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Higher quality primary healthcare associated with reduced hospital admissions for diabetes complications

In a study led by Imperial College London and published online in the journal Diabetic Medicine, researchers from the Department of Primary Care & Public Health at Imperial College London examined if hospital admission rates for diabetes complications (acute complications, chronic complications, no complications and hypoglycaemia) were associated with the management of diabetes in primary care.

We performed an observational study in the population in England during the period 2004–2009 (54 741 278 people registered with 8140 general practices). We used multivariable negative binomial regression to model the associations between indirectly standardized hospital admission rates for complications and primary healthcare quality, supply and access indicators, diabetes prevalence and population factors.

In multivariate regression models, we found that increasing deprivation and diabetes prevalence were risk factors for admission, while most healthcare covariates, i.e. a larger practice population, better patient-perceived urgent and non-urgent access to primary care, and better HbA1c target achievement were associated with lower admission rates. Diabetes admissions decreased significantly during the period 2004–2009.

We concluded that after controlling for population factors, better scheduled primary care access and glycaemic control were associated with lower hospital admission rates across most complications. 

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