Do diabetes clinic attendees stay out of hospital? A matched case-control study

Aims To examine whether routine care for diabetes mellitus influences the r isk of hospital admission. Methods All people with diabetes in five randomly selected general practice s in the city of Leicester were identified from medical records and prescri bing information. Cases with a hospital admission between 1992 and 1995 but no admission in the preceding 2 years were compared with age-matched contr ols in a nested study. Results The variables significantly associated with an increased risk of ad mission were duration of diabetes in years (OR 1.07, 95% confidence interva l (CI) 1.03-1.11) and number of non-diabetic drugs prescribed (OR 1.51, 95% CI 1.27-1.79). Having attended a hospital clinic in the previous 2 years w as associated with reduced risk of admission (OR 0.30, 95% CI 0.14-0.65), w hilst having been seen for a diabetes review in general practice was not (O R 0.91, 95% CI 0.41-1.99). Similar results were found for both diabetes-rel ated and unrelated admissions. Conclusions Although general practice-based review was not associated with a change in the risk of admission, attendance at a hospital clinic was asso ciated with a decreased risk of admission. These results may be explained b y the characteristics of those who attend hospital clinics, as well as by t he possible effectiveness of access to specialist services in reducing admi ssions.