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GP-led diabetes service ‘effective’ in preventing hospital admissions

An enhanced primary care service for type 2 diabetes has been found to be as effective in preventing unscheduled hospital admissions as integrated services involving secondary care specialists, a study has found.

The study, published in Primary Care Diabetes, found that over a 12 month period, there was no significant difference in number of patients having overnight stays in hospital between patient groups receiving the enhanced primary care service and those receiving the standard integrated secondary care approach.

The researchers from the Leicester Diabetes Centre looked at 6,054 type 2 diabetic patients attending practices offering the enhanced service, consisting of GPs and nurses with a special interest in diabetes who attended monthly diabetes education meetings and provided care plans for patients. It compared them with 2,312 at demographic-matched practices receiving the standard integrated secondary care-led service.

Over the 12 month follow up period it was found that the mean difference in non-elective overnight hospital stays was -0.91 per 100 patients in the enhanced service group, suggesting a general trend towards a decrease in hospitalisations for this intervention.

There was, however, no significant difference in number of non-elective overnight hospital stays between the enhanced and secondary care-led service groups.

The findings, suggest the researchers, mean that this approach could offer a safe way for type 2 diabetics to receive better continuity of care closer to their own homes and also have the potential to make community diabetes care more cost-effective.

‘The prevention of an increment in the outcomes has the potential to make the enhanced diabetes service more cost-effective as diabetes service delivery in specialist settings tend to be more expensive,’ they said.

‘These findings are of relevance to policy makers in countries with well-established primary care services who aim to provide a safe and good quality care away from specialist centres, which are associated with increasing costs of delivering hospital inpatient care.’

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