Informing the development of a national diabetes register in
Ireland: a literature review of the impact of patient registration
on diabetes care

O'Mullane, Monica; McHugh, Sheena; Bradley, Colin

doi:10.14236/jhi.v18i3.768

Cited by 14 publications

(13 citation statements)

References 34 publications

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“…Patient registration is considered a starting point for wider quality improvement; without knowing and tracking the patient population, we cannot monitor and improve the patient's experience or health status, and we cannot adequately plan to meet the needs of the population 23. Participants in this study recognised the benefits of a national diabetes register for policy and planning at a national level but were uncertain about the benefits for individual patients and GPs at a practice level.…”

Section: Discussionmentioning

confidence: 95%

‘It sounds like a great idea but…’: a qualitative study of GPs’ attitudes towards the development of a national diabetes register

et al. 2014

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Section: Discussionmentioning

confidence: 95%

‘It sounds like a great idea but…’: a qualitative study of GPs’ attitudes towards the development of a national diabetes register

et al. 2014

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“…The Finnish results of T1D care measured with HbA 1c are not very good but still comparative with other countries [16]. Benchmarking is very problematic before we have national diabetes registers in all countries and before laboratory results are truly comparative and automatically available on the whole population from data systems [17,18]. …”

Section: Discussionmentioning

confidence: 99%

A comparative study of two various models of organising diabetes follow-up in public primary health care – the model influences the use of services, their quality and costs

Honkasalo

Linna

Sane

et al. 2014

BMC Health Serv Res

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BackgroundIn Finland diabetologists have long been concerned about the level of diabetes care as the incidence of type 1 diabetes and complicated type 2 diabetes is exceeding the capacity of specialist clinics. We compared the outcome of diabetes care in two middle-sized Finnish municipalities with different models of diabetes care organisation in public primary health care. In Kouvola the primary health care of all diabetic patients is based on general practitioners, whereas in Nurmijärvi the follow-up of type 1 and most complicated type 2 diabetic patients is assigned to a general practitioner specialised in diabetes care.MethodsOur study population consisted of all adult diabetic patients living in the municipalities under review.We compared the use and costs of public diabetes care, glycemic control, blood pressure, LDL-cholesterol level, the application of the national guidelines and patient satisfaction. The main outcome measures were the costs and use of health care services due to diabetes and its complications.ResultsIn Nurmijärvi, where diabetes care was centralised, more type 1 diabetic patients were followed up in primary health care than in Kouvola, where general practitioners need more specialist consultations. The centralisation resulted in cost savings in the diabetes care of type 1 diabetic patients. Although the quality of care was similar, type 1 diabetic patients were more satisfied with their follow-up in the centralised system. In the care of type 2 diabetic patients the centralised system required fewer specialist consultations, but the quality and costs were similar in both models.ConclusionsThe follow-up of most diabetic patients – including type 1 diabetes – can be organised in primary health care with the same quality as in secondary care units. The centralised primary care of type 1 diabetes is less costly and requires fewer specialist consultations.

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“…However, recruitment from the community proved impractical due to the lack of a diabetes register in the RoI. 17 Matching is a technique used to reduce confounding. 34 Ideally, controls would be frequency-matched for duration of disease to avoid cases having more advanced disease than controls.…”

Section: Discussionmentioning

confidence: 99%

“…Ideally, cases would be identified from a diabetes register, if one existed. 17 Cases will instead be identified from hospital discharge data from three regional centres for diabetes care with a dedicated vascular surgeon between 2006 and 2012. Exclusion criteria are predefined (box 1).…”

Section: Methods Designmentioning

confidence: 99%

Timing of access to secondary healthcare services for diabetes management and lower extremity amputation in people with diabetes: a protocol of a case–control study

et al. 2013

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BackgroundLower extremity amputation (LEA) is a complication of diabetes and a marker of the quality of diabetes care. Clinical and sociodemographic determinants of LEA in people with diabetes are well known. However, the role of service-related factors has been less well explored. Early referral to secondary healthcare is assumed to prevent the occurrence of LEA. The objective of this study is to investigate a possible association between the timing of patient access to secondary healthcare services for diabetes management, as a key marker of service-related factors, and LEA in patients with diabetes.Methods/designThis is a case–control study. The source population is people with diabetes. Cases will be people with diabetes who have undergone a first major LEA, identified from the hospital discharge data at each of three regional centres for diabetes care. Controls will be patients with diabetes without LEA admitted to the same centre either electively or as an emergency. Frequency-matching will be applied for gender, type of diabetes, year and centre of LEA. Three controls per case will be selected from the same population as the cases. With a power of 90% to detect OR of 0.4 for an association between ‘good quality care’ and LEA in people with diabetes, 107 cases and 321 controls are required. Services involved in diabetes management are endocrinology, ophthalmology, renal, cardiology, vascular surgery and podiatry; timing of first contact with any of these services is the main exploratory variable. Using unconditional logistic regression, an association between this exposure and the outcome of major LEA in people with diabetes will be explored, while adjusting for confounders.Ethics and disseminationEthical approval was granted by the Clinical Research Ethics Committee of the Cork Teaching Hospitals, Ireland. Results will be presented at conferences and published in peer-reviewed journals.

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Informing the development of a national diabetes register in Ireland: a literature review of the impact of patient registration on diabetes care

Cited by 14 publications

References 34 publications

‘It sounds like a great idea but…’: a qualitative study of GPs’ attitudes towards the development of a national diabetes register

‘It sounds like a great idea but…’: a qualitative study of GPs’ attitudes towards the development of a national diabetes register

A comparative study of two various models of organising diabetes follow-up in public primary health care – the model influences the use of services, their quality and costs

Timing of access to secondary healthcare services for diabetes management and lower extremity amputation in people with diabetes: a protocol of a case–control study

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