Building the evidence for integrated care for type 2 diabetes: a pilot study
Jessica L. Browne A B F , Jane Speight A B C , Carina Martin D and Christopher Gilfillan EA The Australian Centre for Behavioural Research in Diabetes, Diabetes Australia – Victoria, 570 Elizabeth Street, Melbourne, Vic. 3000, Australia.
B Centre for Mental Health and Wellbeing Research, School of Psychology, Deakin University, 221 Burwood Highway, Burwood, Vic. 3125, Australia.
C AHP Research, 16 Walden Way, Hornchurch, RM11 2 LB, UK.
D Carrington Health, 3/43 Carrington Road, Box Hill, Vic. 3128, Australia.
E Eastern Health Clinical School, Monash University, Level 2, 5 Arnold Street, Box Hill, Vic. 3128, Australia.
F Corresponding author. Email: jbrowne@acbrd.org.au
Australian Journal of Primary Health 22(5) 409-415 https://doi.org/10.1071/PY15020
Submitted: 4 February 2015 Accepted: 20 July 2015 Published: 2 September 2015
Abstract
Integrated care models have the potential to reduce fragmentation in the health system and improve outcomes for people with type 2 diabetes. A pilot evaluation of an integrated care model for people with type 2 diabetes in Melbourne, Australia, is reported on. Two studies were conducted: (1) a 6-month pilot randomised controlled trial (n = 56) evaluating the impact of the integrated care model relative to hospital outpatient clinics; and (2) a cross-sectional study (n = 92) of patients attending the two services. The primary outcome was diabetes-specific distress; secondary outcomes were perceived quality of diabetes care, diabetes-specific self-efficacy and glycated haemoglobin (HbA1c). There was no effect of service setting on diabetes-specific distress. Participants from the integrated care setting perceived the quality of diabetes care to be higher than did participants from the hospital clinics. Significant HbA1c improvements were observed over time, but with no effect of service setting. The model holds promise for people with type 2 diabetes who need more specialist/multidisciplinary care than can be provided in primary care. Patients’ evaluations of the quality of diabetes care received at the integrated care service are very positive, which is likely to be one of the key strengths of the integrated model.
Additional keywords: patient satisfaction, quality of care, questionnaire, randomised controlled trial.
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