UTILIZATION OF PHYSICIAN, NURSING AND DIETICIAN SERVICES BY TYPE 2 DIABETIC PATIENTS ATTENDING PRIMARY CARE CLINICS IN SINGAPORE

Author(s)

Toh MPHS, Wu CXNational Healthcare Group, Singapore, Singapore, Singapore

OBJECTIVES: Physicians, Nursing Care Managers (CMs) and Dieticians are part of the healthcare team looking after patients with diabetes mellitus at the 9 public sector primary care clinics in the National Healthcare Group (NHG) in Singapore. This paper studies the association between the level of glycaemic control and the utilization of these professional services by type 2 diabetes mellitus (T2DM) patients at these clinics. METHODS: This study included all patients with T2DM who had attended the same clinics in 2009 for at least 12 months for the treatment of diabetes. Data was extracted from the NHG Diabetes Registry (CDMS). The number of outpatient clinic visits to the Physicians, CMs and Dieticians in a year was compared by age and degree of glycaemic control using the mean glycated haemoglobin (HbA1c) for the year, “Optimal” being <7%, “Acceptable” 7-9% and “Poor” 9+%. RESULTS: There were 58,057 T2DM patients with more females (54%) and disproportionately more Indians (13%) and fewer Chinese (71%) than the general population. Mean HbA1c was 7.42±1.27% which decreased gradually with age from 8.16% (<40 years) to 6.86% (90+ years). The annual Physician attendances for diabetes consult increased from 4.1±1.5 (“Optimal” HbA1c control) to 5.2±2.2 (“Poor” control), representing 85-89% of all Physician attendances for the year. Proportion of patients seen by the CMs increased from 6.8% (“Optimal” control) to 52.5% (“Poor” control), and similar for Dieticians, an increase from 1.3% (“Optimal” control) to 9.5% (“Poor” control). CONCLUSIONS: T2DM patients with “Optimal” glycaemic control had significantly fewer clinic visits to the healthcare team than those with “Poor” control, translating to lower overall healthcare costs for the patients and the healthcare system. More attention is needed to improve the care of the patients with “Poor” glycaemic control, in order to achieve better long-term health outcomes and reduce healthcare utilization and costs.

Conference/Value in Health Info

2011-05, ISPOR 2011, Baltimore, MD, USA

Value in Health, Vol. 14, No. 3 (May 2011)

Code

PDB35

Topic

Economic Evaluation

Topic Subcategory

Cost/Cost of Illness/Resource Use Studies

Disease

Diabetes/Endocrine/Metabolic Disorders

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