Does the shortage of diabetes specialists in regional and rural Australia matter?

Results from Diabetes MILES-Australia

T. Skinner, P. Allen, E. Peach, J.L. Browne, F. Pouwer, J. Speight, J. Dunbar

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Aim
To investigate differences in access to services and health outcomes between people living with Type 1 (T1DM) and Type 2 (T2DM) diabetes in rural/regional and metropolitan areas.
Methods
Diabetes MILES—Australia was a national postal/online survey of persons registered with the National Diabetes Services Scheme. Selected variables, including utilisation of health care services and self-care indicators, were analysed for 3338 respondents with T1DM (41%) or T2DM (59%).
Results
Respondents from rural/regional (n = 1574, 48%) and metropolitan areas were represented equally (n = 1700, 52%). After adjusting for diabetes duration, demographic and socioeconomic variables, rural/regional respondents with T1DM (RR 0.90, 95% CI 0.83–0.97) and T2DM (RR 0.69, 95% CI 0.59–0.81) were less likely to report consulting an endocrinologist during the past 12 months. Rural/regional respondents with T1DM were more than twice as likely to have accessed a community/practice nurse for diabetes care (RR 2.22, 95% CI 1.25–3.93) while those with T2DM were more likely to have accessed a diabetes educator (RR 1.21, 95% CI 1.07–1.36) or dietician (RR 1.17, 95% CI 1.07–1.36). For the T1DM and T2DM groups were no differences between rural/regional and metropolitan respondents in self-reported hypoglycaemic events during past week and the majority of self-care indicators.
Conclusions
Despite a lack of access to medical specialists, respondents with T1DM and T2DM living in rural/regional areas did not report worse health or self-care indicators. The results suggest that multidisciplinary primary services in rural areas may be providing additional care for people with diabetes, compensating for poor access to specialists.
Keywords: Diabetes management, Health indicators, Rural, Access to healthcare
Original languageEnglish
Pages (from-to)222-229
JournalDiabetes Research and Clinical Practice
Volume100
Issue number2
DOIs
Publication statusPublished - 2013

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Health Services
Hypoglycemic Agents
Type 2 Diabetes Mellitus
Surveys and Questionnaires
Nurses
Delivery of Health Care
Endocrinologists

Cite this

Skinner, T. ; Allen, P. ; Peach, E. ; Browne, J.L. ; Pouwer, F. ; Speight, J. ; Dunbar, J. / Does the shortage of diabetes specialists in regional and rural Australia matter? Results from Diabetes MILES-Australia. In: Diabetes Research and Clinical Practice. 2013 ; Vol. 100, No. 2. pp. 222-229.
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abstract = "AimTo investigate differences in access to services and health outcomes between people living with Type 1 (T1DM) and Type 2 (T2DM) diabetes in rural/regional and metropolitan areas.MethodsDiabetes MILES—Australia was a national postal/online survey of persons registered with the National Diabetes Services Scheme. Selected variables, including utilisation of health care services and self-care indicators, were analysed for 3338 respondents with T1DM (41{\%}) or T2DM (59{\%}).ResultsRespondents from rural/regional (n = 1574, 48{\%}) and metropolitan areas were represented equally (n = 1700, 52{\%}). After adjusting for diabetes duration, demographic and socioeconomic variables, rural/regional respondents with T1DM (RR 0.90, 95{\%} CI 0.83–0.97) and T2DM (RR 0.69, 95{\%} CI 0.59–0.81) were less likely to report consulting an endocrinologist during the past 12 months. Rural/regional respondents with T1DM were more than twice as likely to have accessed a community/practice nurse for diabetes care (RR 2.22, 95{\%} CI 1.25–3.93) while those with T2DM were more likely to have accessed a diabetes educator (RR 1.21, 95{\%} CI 1.07–1.36) or dietician (RR 1.17, 95{\%} CI 1.07–1.36). For the T1DM and T2DM groups were no differences between rural/regional and metropolitan respondents in self-reported hypoglycaemic events during past week and the majority of self-care indicators.ConclusionsDespite a lack of access to medical specialists, respondents with T1DM and T2DM living in rural/regional areas did not report worse health or self-care indicators. The results suggest that multidisciplinary primary services in rural areas may be providing additional care for people with diabetes, compensating for poor access to specialists.Keywords: Diabetes management, Health indicators, Rural, Access to healthcare",
author = "T. Skinner and P. Allen and E. Peach and J.L. Browne and F. Pouwer and J. Speight and J. Dunbar",
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Does the shortage of diabetes specialists in regional and rural Australia matter? Results from Diabetes MILES-Australia. / Skinner, T.; Allen, P.; Peach, E.; Browne, J.L.; Pouwer, F.; Speight, J.; Dunbar, J.

In: Diabetes Research and Clinical Practice, Vol. 100, No. 2, 2013, p. 222-229.

Research output: Contribution to journalArticleScientificpeer-review

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T1 - Does the shortage of diabetes specialists in regional and rural Australia matter?

T2 - Results from Diabetes MILES-Australia

AU - Skinner, T.

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AU - Speight, J.

AU - Dunbar, J.

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N2 - AimTo investigate differences in access to services and health outcomes between people living with Type 1 (T1DM) and Type 2 (T2DM) diabetes in rural/regional and metropolitan areas.MethodsDiabetes MILES—Australia was a national postal/online survey of persons registered with the National Diabetes Services Scheme. Selected variables, including utilisation of health care services and self-care indicators, were analysed for 3338 respondents with T1DM (41%) or T2DM (59%).ResultsRespondents from rural/regional (n = 1574, 48%) and metropolitan areas were represented equally (n = 1700, 52%). After adjusting for diabetes duration, demographic and socioeconomic variables, rural/regional respondents with T1DM (RR 0.90, 95% CI 0.83–0.97) and T2DM (RR 0.69, 95% CI 0.59–0.81) were less likely to report consulting an endocrinologist during the past 12 months. Rural/regional respondents with T1DM were more than twice as likely to have accessed a community/practice nurse for diabetes care (RR 2.22, 95% CI 1.25–3.93) while those with T2DM were more likely to have accessed a diabetes educator (RR 1.21, 95% CI 1.07–1.36) or dietician (RR 1.17, 95% CI 1.07–1.36). For the T1DM and T2DM groups were no differences between rural/regional and metropolitan respondents in self-reported hypoglycaemic events during past week and the majority of self-care indicators.ConclusionsDespite a lack of access to medical specialists, respondents with T1DM and T2DM living in rural/regional areas did not report worse health or self-care indicators. The results suggest that multidisciplinary primary services in rural areas may be providing additional care for people with diabetes, compensating for poor access to specialists.Keywords: Diabetes management, Health indicators, Rural, Access to healthcare

AB - AimTo investigate differences in access to services and health outcomes between people living with Type 1 (T1DM) and Type 2 (T2DM) diabetes in rural/regional and metropolitan areas.MethodsDiabetes MILES—Australia was a national postal/online survey of persons registered with the National Diabetes Services Scheme. Selected variables, including utilisation of health care services and self-care indicators, were analysed for 3338 respondents with T1DM (41%) or T2DM (59%).ResultsRespondents from rural/regional (n = 1574, 48%) and metropolitan areas were represented equally (n = 1700, 52%). After adjusting for diabetes duration, demographic and socioeconomic variables, rural/regional respondents with T1DM (RR 0.90, 95% CI 0.83–0.97) and T2DM (RR 0.69, 95% CI 0.59–0.81) were less likely to report consulting an endocrinologist during the past 12 months. Rural/regional respondents with T1DM were more than twice as likely to have accessed a community/practice nurse for diabetes care (RR 2.22, 95% CI 1.25–3.93) while those with T2DM were more likely to have accessed a diabetes educator (RR 1.21, 95% CI 1.07–1.36) or dietician (RR 1.17, 95% CI 1.07–1.36). For the T1DM and T2DM groups were no differences between rural/regional and metropolitan respondents in self-reported hypoglycaemic events during past week and the majority of self-care indicators.ConclusionsDespite a lack of access to medical specialists, respondents with T1DM and T2DM living in rural/regional areas did not report worse health or self-care indicators. The results suggest that multidisciplinary primary services in rural areas may be providing additional care for people with diabetes, compensating for poor access to specialists.Keywords: Diabetes management, Health indicators, Rural, Access to healthcare

U2 - 10.1016/j.diabres.2013.03.015

DO - 10.1016/j.diabres.2013.03.015

M3 - Article

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JF - Diabetes Research and Clinical Practice

SN - 0168-8227

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