Table 2 Diabetes-related hospital outcome measures and primary health care resource inputs and direction of significant study findings
First author, date published (country) | Hospital outcome measure | Primary health care resource inputs and direction of significant study findings | ||
|---|---|---|---|---|
Category of diabetes-related ACSC (reporting of results) | Description of how measured (level of variable) | PHC resources significantly associated with an increase [↑] or decrease [↓] in hospitalisationa (level of variable) | PHC variables that were not significant i.e. p value >0.05, or reference measure (level of variable) | |
Dusheiko 2011 (England) | Emergency (unplanned) hospitalisations due to (all) short-term diabetic complicationsb (incidence rate) | Incidence rate per family practice (health centre) (f) | Nil | Population per FTE family physician (f) |
Griffiths 2010 (England) | Non-elective diabetes-related hospitalisations (rate per facility) | Rate per number of patients on the register experiencing ≥ 1 hospitalisation (f) | Increase in the number of patients per FTE GP(f) [↓]c <3038 patients per FTE practice nurse (f) [↑] 3039–3901 patients per FTE practice nurse (f) [↑] 4823–6210 patients per FTE practice nurse (f) [↓] 6210+ patients per FTE practice nurse (f) [↓] | Sole practitioner practice (f) Primary medical service contract (f) 3901–4823 patients per FTE practice nurse i.e. Quintile 3 (f) |
|  |  | Rate per number of patients on the register experiencing ≥ 2 hospitalisation (f) | Number of patients per FTE GP (f) [↓] <3038 patients per FTE practice nurse (f) [↑] 3901–4823 patients per FTE practice nurse (f) [↑] | Sole practitioner practice (f) Primary medical service contract (f) 3039–3901 patients per FTE practice nurse i.e. Quintile 2 (f) 4823–6210 patients per FTE practice nurse (f) i.e. Quintile 4 6210+ patients per FTE practice nurse (f) i.e. Quintile 5 |
Lavoie 2010 (Canada) | Chronic ACSC hospitalisation (rate difference) | Average difference in rates of hospitalisation between level of primary care serviced (f) | Health centre versus no facility (f) [↓] Health office versus no facility (f) [↓] Health centre versus nursing station (f) [↑] Health office versus nursing station (f) [↑] | Nursing station and no facility (f) |
Ng 2010 (Canada) | An acute hospitalisation for any reason among persons age 12 years or older with type 2 diabetes (odds ratio) | Status of hospitalisation (yes or no) (i) | An increase in self-reported number of GP contacts in the previous 12 months [↓] | Nil |
Bruni 2009 (Italy) | Hyperglycemic emergency hospitalisations (probability of being hospitalised) | Hospitalised, yes or no (i) | As number of visits to diabetes outreach clinic increased (i) [↑] More patients per gp 1100–1500 and >1500 (iGP) [↑] Larger proportion of annual income from pay-for-participation (GP payments related to number of patients with diabetes) (iGP) [↓] Health district receives ≥75 % GP income from incentive schemes (d) [↓] | Patients per GP <1100 (ref) Practice type, i.e. sole practitioner (ref), association, network, group (iGP) Per cent diabetic patients (iGP) Per cent annual income pay-for-compliance (GP payments related to the number of quality improvement processes involved in e.g. diabetes audit) (iGP) Health district receives 25–75 % GP income from incentives schemes (d) |
El-Din 2009 (Saudi Arabia) | Type 2 diabetes related hospitalisation (odds of being hospitalised) | Hospitalised, yes or no (i) | ≥ 6 outpatient PHC clinic visits, except diabetes clinic (i) [↑] | No outpatient clinic visits (ref) (i) 1–5 outpatient clinic visits (i) |
Lin 2009 (Taiwan) | Short-term diabetes ACSC and long-term ACSC modelled separately (relative risk ratio) | Status of hospitalisation (yes or no) (i) | More outpatient diabetes visits per year (i) [↑] | Diabetes management received (primary care clinic (ref), medical centre, regional or district hospitals (i) |
Rizza 2007 (Italy) | Hospitalisation for diabetes ambulatory care sensitive conditions (odds ratio) | Status of hospitalisation (yes or no) (i) | As the number of patients per primary care physician increases (iGP) [↑] | Number of primary care physician visits in previous year (i) Number of specialist visits in community health services (f) |
Gulliford 2004e (England) | Hospitalisation for chronic conditions (chronic hospital admissions per 100 000 persons) | Rate of hospitalisation per 100 000 persons (ha)f | As GP supply increases per 10 000 weighted population (ha) [↓] As mean partnership size increases (ha) [↓] As proportion of sole provider practices increase (ha) [↑] | Per cent practices with diabetes service (ha) |
Gulliford 2002e (England) | Hospitalisation for chronic conditions (chronic hospital admissions per 100 000 persons) | Rate of hospitalisation per 100 000 persons (ha) | As GP supply increases per 10 000 persons (ha) [↓] | Nil |