Use of primary health care services among older patients with and without diabetes

Anna-Kaisa Aro; Merja Karjalainen; Miia Tiihonen; Hannu Kautiainen; Juha Saltevo; Maija Haanpää; Pekka Mäntyselkä

doi:10.1186/s12875-022-01844-2

Use of primary health care services among older patients with and without diabetes

BMC Prim Care. 2022 Sep 9;23(1):233. doi: 10.1186/s12875-022-01844-2.

Authors

Anna-Kaisa Aro^{1

2}, Merja Karjalainen³, Miia Tiihonen⁴, Hannu Kautiainen⁵, Juha Saltevo⁶, Maija Haanpää⁷, Pekka Mäntyselkä^{8

9}

Affiliations

¹ Insitute of Public Health and Clinical Nutrition, General Practice, University of Eastern Finland, PO Box 1627, FI-70211, Kuopio, Finland. koistine@uef.fi.
² Rantakylä Health Center, Joensuu, Finland. koistine@uef.fi.
³ Siilinjärvi Health Center, Siilinjärvi, Finland.
⁴ School of Pharmacy, University of Eastern Finland, Kuopio, Finland.
⁵ Unit of Primary Health Care, Helsinki University Central Hospital, Helsinki, Finland.
⁶ Central Finland Central Hospital, Jyväskylä, Finland.
⁷ Ilmarinen Mutual Pension Insurance Company, Helsinki, Finland.
⁸ Insitute of Public Health and Clinical Nutrition, General Practice, University of Eastern Finland, PO Box 1627, FI-70211, Kuopio, Finland.
⁹ Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland.

Abstract

Background: The aim of this study was to compare the utilization of primary healthcare services by older patients with and without type 2 diabetes.

Methods: Electronic patient records were used to identify persons over 65 years of age with a diagnosis of diabetes. Two age- and sex-adjusted controls without diabetes were extracted for each person with diagnosis of diabetes. A health questionnaire was sent by mail to 527 people with diabetes and 890 controls. Of the persons who answered the questionnaire, 518 persons were randomly selected to participate in a health examination. The study group in this analysis consisted of 187 persons with diabetes and 176 persons without diabetes who attended the health examination. The data on primary health care utilization were extracted from electronic patient records one year before and one after the health examination.

Results: Before the onset of the study, the patients with diabetes had more doctor's appointments (p < 0.001), nurse's appointments (< 0.001) and laboratory tests taken (p < 0.001) than those without diabetes After 1-year follow-up period the patients with diabetes had more doctor's appointments (p = 0.002), nurse's appointments (p = 0.006), laboratory tests taken (p = 0.006) and inpatient care at the community hospital (p = 0.004) than patients without a diagnosis of type 2 diabetes. The use of the community hospital increased significantly among patients with diabetes (ratio 2.50; 95% Cl 1.16-5.36) but not by patients without diabetes (ratio 0.91; 95% Cl 0.40.2.06). The number of nurse's appointments increased for patients without diabetes (ratio 1.31; 95% Cl 1.07-1.60) but not for those with diabetes (ratio 1.04; 95% Cl 0.88-1.24).

Conclusions: Patients with diabetes visit more often physicians and nurses compared with those without diabetes. During a 1-year follow-up, the use of community hospital care increased significantly among patients with diabetes. In addition to focusing on prevention and care of diabetes, these results suggest the importance of diabetes in planning community-based health care services.

Keywords: Healthcare use; Older patients; Primary care; Type 2 diabetes.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Appointments and Schedules
Diabetes Mellitus, Type 2* / epidemiology
Health Services
Humans
Primary Health Care / methods
Surveys and Questionnaires