Service use of young people with Type 1 diabetes after transition from paediatric to adult-based diabetes health care

被引:4
作者
Perry, Lin [1 ,2 ]
Dunbabin, Janet [3 ]
Xu, Xiaoyue [1 ,3 ]
Lowe, Julia [3 ]
Acharya, Shamasunder [4 ]
James, Steven [5 ]
Steinbeck, Katharine S. [6 ,7 ]
机构
[1] Univ Technol Sydney, Fac Hlth, 15 Broadway, Ultimo, NSW 2007, Australia
[2] Prince Wales Hosp, South Eastern Sydney Local Hlth Dist, 320-346 Barker St, Randwick, NSW 2031, Australia
[3] Univ Newcastle, Fac Hlth & Med, Univ Dr, Callaghan, NSW 2308, Australia
[4] John Hunter Hosp, Hunter New England Local Hlth Dist, Lookout Rd, New Lambton Hts, NSW 2305, Australia
[5] Univ Sunshine Coast, Sch Nursing Midwifery & Paramed, 80-106 Tallon St, Caboolture, Qld 4510, Australia
[6] Univ Sydney, Discipline Paediat & Child Hlth, Camperdown, NSW 2006, Australia
[7] Childrens Hosp Westmead, Dept Adolescent Med, Corner Hawkesbury Rd & Hainsworth St, Westmead, NSW 2145, Australia
基金
英国医学研究理事会;
关键词
access; adolescents; appointments; young adults; EXPERIENCES; PROGRAM;
D O I
10.1071/AH19117
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Objective The aim of this study was to determine, in the first 2 years after the last planned appointment with paediatric diabetes services for young people with Type 1 diabetes (T1D): (1) the number of planned and unplanned healthcare contacts and HbA1c measurements made; (2) factors linked to diabetes-related service use; and (3) factors predictive of the number of planned and unplanned service contacts, and of meeting the minimum number of planned service contacts. Methods Healthcare records of a major public healthcare provider in Australia were audited for preventive and acute service use by young people with T1D transferring from paediatric to adult public healthcare services. Statistical analyses included use of t-tests and logistic regression modelling. Results Of 172 young people with T1D, 21% had no planned specialist care and 49% accessed acute services for diabetes-related matters. Residents of metropolitan areas and users of continuous subcutaneous insulin infusion therapy were more likely to access specialist care and were less likely to use acute services for unplanned care. Those achieving a minimum of nine planned care contacts in 2 years had a shorter duration between the last paediatric and first adult healthcare contact. Conclusions Lack of specialist care in early adult years and non-metropolitan relative disadvantage compromise the present and future health of young people with diabetes. What is known about the topic? Well-managed transition is thought to offer the best chance of achieving cost-effective continuing engagement with specialist services for planned preventive care, effective T1D self-management and deferral or early attention to diabetes-related vascular complications. However, transition is commonly reported as problematic. What does this paper add? The findings of this study indicate a positive trend but continuing need to improve transition care for young people with T1D, especially those living in non-metropolitan areas and those not using continuous subcutaneous insulin infusion therapy. What are the implications for practitioners? Without service innovation, suboptimal and delayed access to planned care, high use of acute services for unplanned care and poor glycaemic control will continue to threaten the future health and well-being of young people with T1D.
引用
收藏
页码:601 / 608
页数:8
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