Abstract
Aims
We aimed to characterise use of general practitioners (GP) simultaneously across multiple
attributes in people with diabetes and examine its impact on diabetes related potentially
preventable hospitalisations (PPHs).
Methods
Five-years of panel data from 40,625 adults with diabetes were sourced from Western
Australian administrative health records. Cluster analysis (CA) was used to group
individuals with similar patterns of GP utilisation characterised by frequency and
recency of services. The relationship between GP utilisation cluster and the risk
of PPHs was examined using multivariable random-effects negative binomial regression.
Results
CA categorised GP utilisation into three clusters: moderate; high and very high usage,
having distinct patient characteristics. After adjusting for potential confounders,
the rate of PPHs was significantly lower across all GP usage clusters compared with
those with no GP usage; IRR = 0.67 (95%CI: 0.62–0.71) among the moderate, IRR = 0.70
(95%CI 0.66–0.73) high and IRR = 0.76 (95%CI 0.72–0.80) very high GP usage clusters.
Conclusions
Combination of temporal factors with measures of frequency of use of GP services revealed
patterns of primary health care utilisation associated with different underlying patient
characteristics. Incorporation of multiple attributes, that go beyond frequency-based
approaches may better characterise the complex relationship between use of GP services
and diabetes-related hospitalisation.
Keywords
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Article info
Publication history
Published online: February 09, 2018
Accepted:
January 26,
2018
Received in revised form:
November 24,
2017
Received:
August 18,
2017
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
