The pattern of diabetes care in New South Wales: a five-year analysis using Medicare occasions of service data

Objective: To use Medicare occasions of service data to establish the patte rn and standard of care received by people with diabetes. Method: Information about visits to medical practitioners as well as utilis ation of diabetes related procedures for people living in New South Wales ( NSW) for the individual years between 1993 to 1997 was retrieved using a He alth insurance Commission data file. Individuals were deemed to have diabet es if an Hb(A1c) which can only be ordered for a person with known diabetes , had been performed over the live-year period. Results: On average over the study period, persons with diabetes accounted for 3.1% of the population but they used 5.5% of general practitioner servi ces. A large proportion of patients also received care at the specialist an d consultant physician level, 51.2% and 38.6% respectively, a three to four fold increase when compared with their non-diabetic counterparts. There wa s also a 1.3 to 1.8 fold increase in the mean number of attendances to the various medical practitioners. Surveillance of diabetes parameters was inad equate but small improvements were seen over the 5 year study period (propo rtion of persons with diabetes with a Hb(A1c) performed: 48.8% to 56.8%; Li pids: 49.4% to 52.0%; HDL cholesterol: 18.3% to 18.8%; microalbuminuria: 4. 7% to 11.6%). Conclusion: This study has highlighted the heavy burden imposed by diabetes an our health care system. Implications: The use of Medicare occasions of service data represents a co st efficient way of monitoring health service utilisation.