Use of primary health care services among older patients with and without diabetes

Abstract

Background The aim of this study was to compare the utilization of primary healthcare services by older patients with and without type 2 diabetes. Methods Electronic patient records were used to identify persons over 65 years of age with a diagnosis of diabetes. Two age- and sex-adjusted controls without diabetes were extracted for each person with diagnosis of diabetes. A health questionnaire was sent by mail to 527 people with diabetes and 890 controls. Of the persons who answered the questionnaire, 518 persons were randomly selected to participate in a health examination. The study group in this analysis consisted of 187 persons with diabetes and 176 persons without diabetes who attended the health examination. The data on primary health care utilization were extracted from electronic patient records one year before and one after the health examination. Results Before the onset of the study, the patients with diabetes had more doctor’s appointments (p < 0.001), nurse’s appointments (< 0.001) and laboratory tests taken (p < 0.001) than those without diabetes After 1-year follow-up period the patients with diabetes had more doctor’s appointments (p = 0.002), nurse’s appointments (p = 0.006), laboratory tests taken (p = 0.006) and inpatient care at the community hospital (p = 0.004) than patients without a diagnosis of type 2 diabetes. The use of the community hospital increased significantly among patients with diabetes (ratio 2.50; 95% Cl 1.16–5.36) but not by patients without diabetes (ratio 0.91; 95% Cl 0.40.2.06). The number of nurse’s appointments increased for patients without diabetes (ratio 1.31; 95% Cl 1.07–1.60) but not for those with diabetes (ratio 1.04; 95% Cl 0.88–1.24). Conclusions Patients with diabetes visit more often physicians and nurses compared with those without diabetes. During a 1-year follow-up, the use of community hospital care increased significantly among patients with diabetes. In addition to focusing on prevention and care of diabetes, these results suggest the importance of diabetes in planning community-based health care services.

Accessibility and utilization of healthcare services among diabetic patients: Is diabetes a poor man’s ailment?

“…A study conducted by Shalev et al [ 33 ] revealed that gender influences the utilization of health care services as females use more health care services and have a high morbidity rate compared to males. Shalev et al [ 33 ] and Aro et al [ 34 ] affirmed that patients that are affected by diabetes utilized medical care more compared with their counterparts. Two studies identified factors that limited diabetic patients’ utilization of health care services, which included a lack of finance and transportation that hindered the utilization of health care among diabetic patients[ 35 - 37 ].…”

“…Some empirical studies have identified some aspects of medical care services utilized by diabetic patients. Diabetic patients have been found to utilize outpatient visits, special visits, general practitioner visits, emergency room, and hospitalization[ 14 , 34 ]. This means that diabetic patients value the kinds of medical care services provided by these specialists; however, studies did not disclose the extent of utilization of these services by diabetic patients.…”

Use of primary health care services and mortality in older patients with type 2 diabetes with or without comorbidities

“…In Finland, T2D is the fifth most common cause of general practitioner (GP) appointments [ 10 ]. Older T2D patients seem to use PHC services more often than age- and sex-matched controls without diabetes [ 11 ]. Furthermore, the use of PHC services in patients with T2D seems to increase with the duration of T2D [ 12 , 13 ].…”