Factors affecting the use of dietetic services by patients with diabetes mellitus

Robson, Tracy; Blackwell, David; Waine, Colin; Kennedy, Richard L.

doi:10.1046/j.1464-5491.2001.00471.x

Cited by 14 publications

(9 citation statements)

References 28 publications

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“…These results were in accordance with studies in other healthcare professions [18,31,32]. However, the positive association between patients’ age and a lower number of consultations per treatment was not in accordance with other studies [18,29].…”

Section: Discussionsupporting

confidence: 76%

Factors associated with the number of consultations per dietetic treatment: an observational study

Tol

Swinkels

Spreeuwenberg

et al. 2012

BMC Health Serv Res

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BackgroundGreater understanding of the variance in the number of consultations per dietetic treatment will increase the transparency of dietetic healthcare. Substantial inter-practitioner variation may suggest a potential to increase efficiency and improve quality. It is not known whether inter-practitioner variation also exists in the field of dietetics. Therefore, the aims of this study are to examine inter-practitioner variation in the number of consultations per treatment and the case-mix factors that explain this variation.MethodsFor this observational study, data were used from the National Information Service for Allied Health Care (LiPZ). LiPZ is a Dutch registration network of allied health care professionals, including dietitians working in primary healthcare. Data were used from 6,496 patients who underwent dietetic treatment between 2006 and 2009, treated by 27 dietitians working in solo practices located throughout the Netherlands. Data collection was based on the long-term computerized registration of healthcare-related information on patients, reimbursement, treatment and health problems, using a regular software program for reimbursement. Poisson multilevel regression analyses were used to model the number of consultations and to account for the clustered structure of the data.ResultsAfter adjusting for case-mix, seven percent of the total variation in consultation sessions was due to dietitians. The mean number of consultations per treatment was 4.9 and ranged from 2.3–10.1 between dietitians. Demographic characteristics, patients’ initiative and patients’ health problems explained 28% of the inter-practitioner variation. Certain groups of patients used significantly more dietetic healthcare compared to others, i.e. older patients, females, the native Dutch, patients with a history of dietetic healthcare, patients who started the treatment on their own initiative, patients with multiple diagnoses, overweight, or binge eating disorder.ConclusionsConsiderable variation in number of consultations per dietetic treatment is due to dietitians. Some of this inter-practitioner variation was reduced after adjusting for case-mix. Further research is necessary to study the relation between inter-practitioner variation and the effectiveness and quality of dietetic treatment.

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Section: Discussionsupporting

confidence: 76%

Factors associated with the number of consultations per dietetic treatment: an observational study

Tol

Swinkels

Spreeuwenberg

et al. 2012

BMC Health Serv Res

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“…Panser et al found that age modified by the effect of gender was the strongest risk factor for hospitalisation in patients with type 2 diabetes, while the presence of complications such as coronary heart disease, retinopathy and persistent proteinuria were also significant risk factors [20]. The use of dietetic services is related to gender, disease duration and the use of insulin [21]. Another study showed that nearly one third of the diabetic patients had never visited an ophthalmologist [14].…”

Section: Introductionmentioning

confidence: 99%

Health care use by diabetic patients in the Netherlands: patterns and predicting factors

Fakiri

Foets

Rijken

2003

Diabetes Research and Clinical Practice

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“…Many people with diabetes have never had a consultation with a dietitian. In a study from Sunderland, only 59% of patients had seen a dietitian in the previous eight years, and many patients with impaired renal function or with dyslipidaemia had never seen a dietitian 2. Similarly, in a questionnaire survey of people with diabetes in Herefordshire, only 75% could recall ever having seen a dietitian and, of these, 44% had seen a dietitian only once and a further 18% saw a dietitian only ‘rarely or irregularly’ 3…”

Section: Discussionmentioning

confidence: 99%

“…This evidence of a considerable un‐met need, as perceived by people with diabetes, is unsatisfactory in what should be a patient‐centred service, and particularly so because there is evidence, which has been reviewed in two recent publications,2, 4 that contact with a professional dietitian is clinically effective and also cost effective. In contrast, there is no published evidence for the effectiveness of dietary advice given to people with diabetes by other health professionals, although in a randomised trial of the dietary management of hypercholesterolaemia (in which the dietary advice is very similar to that required by most people with type 2 diabetes), counselling by dietitians achieved greater reductions in LDL cholesterol than did that given by doctors 5…”

Section: Discussionmentioning

confidence: 99%

Why do people with diabetes contact Diabetes UK for dietary advice?

2004

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A survey of 91 e‐mail enquiries to Diabetes UK showed evidence of a substantial un‐met need for better quality dietary advice, both at the time of diagnosis and during follow up. There was evidence of inadequate and inappropriate advice and of conflicting advice from different health care professionals. Many of those who were newly diagnosed were confused about what they should and should not eat. Doctors and nurses who give dietary advice need better training in current nutritional principles. People with type 1 diabetes should be seen by a state registered dietitian within two days of diagnosis and those with type 2 diabetes within one month. All patients should be offered an annual dietetic review with a state registered dietitian and there should be provision for those who need more frequent review. Copyright © 2004 John Wiley & Sons, Ltd.

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Factors affecting the use of dietetic services by patients with diabetes mellitus

Cited by 14 publications

References 28 publications

Factors associated with the number of consultations per dietetic treatment: an observational study

Factors associated with the number of consultations per dietetic treatment: an observational study

Health care use by diabetic patients in the Netherlands: patterns and predicting factors

Why do people with diabetes contact Diabetes UK for dietary advice?

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