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Table 4 Core findings of the effect of primary care resourcing on diabetes-related ambulatory care sensitive hospitalisations

From: A systematic review of evidence on the association between hospitalisation for chronic disease related ambulatory care sensitive conditions and primary health care resourcing

First author, date Primary health care resource variable Direction of association with avoidable hospitalisationsa Supports hypothesisb Comment
Dusheiko 2011 GPs per population Not significant No Adjusted for facility-level prevalence of diabetes, mental health conditions, heart disease
Griffiths 2010 Patients per GP Significant inverse No No adjustment for clinical health risks
Practice nurses per patient Significant inverse No Adjusted for facility-level unadjusted diabetes prevalence
Lavoie 2010 PHC service availability (service categories: no permanent locally based service, part-time, working hours, 24/7 care) Significant inverse Yes No adjustment for health status. Adjustment for age, gender and location but not reported
Ng 2010 GP contacts in the previous 12 months Significant inverse Yes Adjusted for individual-level health utility, other chronic conditions, prior hospitalisations, lifestyle behaviours
Lin 2010 Diabetes outpatient visits Significant positive No Adjusted for number of comorbidities and age
Bruni 2009 Use of diabetes outreach service Significant positive No No adjustment for health status. Adjusted for age. Outreach service use was a proxy of disease severity.
Patients per GP Significant positive Yes
Funding incentives to promote better quality care Significant inverse Yes
El-Din 2009 ≥6 PHC clinic visits Significant positive No Adjusted for presence of nephropathy and HbA1c
Rizza 2007 Patients per GP Significant positive Yes Adjusted for number of hospitalisations in previous year and length of stay and self-reported health status
Gulliford 2004, 2002 GPs per population Significant inverse Yes No adjustment for health status.
  Partnership size Significant inverse Yes Adjusted for proportion of patients per health authority with a limiting long-term illness. Partnership size is a proxy for better access to multi-disciplinary care team.
  1. Notes:
  2. aA positive association means the outcome and exposure variables increase or decrease in the same direction, i.e. more practice nurses per patient results in more hospitalisations. An inverse association means the outcome and exposure variables move in the opposite direction, i.e. more practice nurses per patient results in less hospitalisations.
  3. bMore primary health care resources are associated with lower hospitalisation.