Continuity of care in diabetes: to whom does it matter?

The Australian health care system allows patients to move around to seek me dical treatment. This may impact negatively on continuity of care. To deter mine factors associated with continuity of care for persons with diabetes. the profiles of 479 patients attending the Diabetes Centre, Royal Prince Al fred Hospital. Sydney, Australia, were examined. The majority of patients ( 87.7%) attended only one general practitioner and had been under the care o f the referring doctor for a median of 6.2 years. These patients were older (P = 0.02), but were comparable with those attending multiple doctors in t erms of their type, duration and treatment of diabetes as well as their cli nical and complication profile. There was also a relationship between age a nd the length of time under the care of the referring doctor (P = 0.0002). The HbA(1c), lipid, blood pressure and treatment profiles of patients atten ding the referring doctor short, medium or long-term were comparable. Howev er, there was an upward trend in the promotion of patients with a history o f cerebrovascular disease, ischaemic heart disease or any complication of d iabetes with each incremental increase in length of time under the referrin g doctor. Appropriately. patients seek continuity of care as they age and t heir health needs become more complex. (C) 2001 Elsevier Science Ireland Lt d. All rights reserved.