South Western Sydney Medical School, University of New South Wales, NSW 2170, Australia; and Population Health Intelligence, South Western Sydney Local Health District, Liverpool, NSW 1871, Australia
College of Health and Medicine, Australian National University, Canberra, ACT 0200, Australia
Rural Remote Health. 2021 Aug;21(3):5844. doi: 10.22605/RRH5844. Epub 2021 Aug 2.
Public health agencies around the world are concerned about an ever-increasing burden of type 2 diabetes and related disability. Access to primary care providers (PCPs) can support early diagnosis and management. However, there is limited literature on how frequently older people with diabetes access PCPs, and their levels of access in rural Australia relative to metropolitan areas.
In this research, patterns of PCP use among those with diagnosed diabetes and those without diagnosed diabetes (referred to as 'healthy' individuals) were compared using a large survey of more than 230 000 people aged 45 years and older from New South Wales, Australia. A published model to study the PCP access patterns of a group of individuals with diabetes risk was used.
Annual visits to PCPs among people aged 45 years or more with diabetes in rural areas, while higher than for healthy rural residents, were significantly lower than their metropolitan counterparts, mirroring similar disparities in PCP use across the rural-urban divide in the healthy population. Similar patterns were present in the high-risk population. Nevertheless, people with diabetes visited PCPs around four times a year, which is around the recommended number of annual visits, although some groups (eg those with comorbidities) may need more visits.
Patterns of PCP use among rural residents, while significantly less frequent than their metropolitan counterparts, are at the recommended level for people with diabetes.
世界各地的公共卫生机构都对 2 型糖尿病及其相关残疾的负担不断增加感到担忧。获得初级保健提供者(PCP)的机会可以支持早期诊断和管理。然而,关于糖尿病老年人与大都市地区相比,他们与 PCP 的接触频率以及在农村地区获得 PCP 的情况的文献有限。
在这项研究中,通过对来自澳大利亚新南威尔士州的 230,000 多名 45 岁及以上人群的大型调查,比较了已确诊糖尿病患者和未确诊糖尿病患者(称为“健康”个体)与 PCP 的使用模式。使用了一种已发表的模型来研究一组具有糖尿病风险的个体的 PCP 访问模式。
45 岁及以上农村地区患有糖尿病的人群每年到 PCP 的就诊次数虽然高于农村地区的健康居民,但明显低于大都市地区的居民,这反映了在健康人群中,农村-城市鸿沟中 PCP 使用的类似差距。高危人群也存在类似模式。尽管如此,糖尿病患者每年大约会看 PCP 四次,这大约是推荐的年度就诊次数,尽管有些群体(例如有合并症的群体)可能需要更多的就诊。
虽然农村居民与大都市居民相比,他们与 PCP 的接触频率明显较低,但仍处于糖尿病患者的推荐就诊水平。