Dr. Dahai Yu d.yu@keele.ac.uk
Hospitalisation among patients with diabetes associated with a Diabetes Integrated Care Initiative: a mixed methods case study
Yu
Authors
Abstract
Integrated care has been postulated to result in improvements to diabetes outcomes, including reduced hospitalisation. The Diabetes Integrated Care Initiative (DICI) aimed to integrate primary, secondary and community diabetes care in East Cambridgeshire and Fenland (ECF). The aims of this study were to describe changes in care and hospitalisation rates over the first 3 years of the initiative, 2009–2012. The evaluation involved a mixed-methods approach, including a before-after design with controls from adjacent geographical areas and from patients without diabetes, alongside a 30-month ethnographic study including interviews with patients and health professionals. Over the three years, admission rates among patients with diabetes in the intervention area continued to grow. In fact, the increases in admissions in ECF were 7.4% (95% CI 5.2–9.2) and 45.5% (95% CI 42.5–48.5) greater than in the neighbouring areas of Huntingdonshire and Greater Cambridge, respectively. The rates of increase in diabetic foot, non-elective or other hospital admissions were not reduced. In summary, the DICI was not associated with improved diabetes care or reduced diabetes hospitalisation over the 3 years studied, despite substantial investment. While the principle of integration remains an ideal, linking different providers in ECF, especially those that are positioned between primary and secondary care, created barriers rather than bridges to better diabetes outcomes.
Citation
Yu. (2015). Hospitalisation among patients with diabetes associated with a Diabetes Integrated Care Initiative: a mixed methods case study. Future Hospital Journal, 92 - 98 (7). https://doi.org/10.7861/futurehosp.2-2-92
Acceptance Date | Feb 20, 2015 |
---|---|
Publication Date | Jun 1, 2015 |
Journal | Future Hospital Journal |
Print ISSN | 2055-3323 |
Publisher | Royal College of Physicians |
Pages | 92 - 98 (7) |
DOI | https://doi.org/10.7861/futurehosp.2-2-92 |
Keywords | Diabetes, integrated care, hospital admission, HbA1c hypophysitis, encephalopathy |
Publisher URL | http://futurehospital.rcpjournal.org/content/2/2/92.abstract |
You might also like
Where does it hurt? Small area estimates and inequality in the prevalence of chronic pain
(2023)
Journal Article
Downloadable Citations
About Keele Repository
Administrator e-mail: research.openaccess@keele.ac.uk
This application uses the following open-source libraries:
SheetJS Community Edition
Apache License Version 2.0 (http://www.apache.org/licenses/)
PDF.js
Apache License Version 2.0 (http://www.apache.org/licenses/)
Font Awesome
SIL OFL 1.1 (http://scripts.sil.org/OFL)
MIT License (http://opensource.org/licenses/mit-license.html)
CC BY 3.0 ( http://creativecommons.org/licenses/by/3.0/)
Powered by Worktribe © 2024
Advanced Search