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District Level Hospital Diabetic Patients Referred to Intermediate Care: A Descriptive Analysis
Background Diabetes mellitus contributes considerably to morbidity and mortality. By analysing a South African cohort with diabetes-related adverse outcomes, the researchers felt that reviewing their past primary care may reveal contributing factors resulting in these outcomes. Methods A retrospecti...
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| Format: | Thesis |
| Language: | English |
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Department of Public Health and Family Medicine
2024
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| _version_ | 1867613265192812544 |
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| access_status_str | Open Access |
| author | Jansen, Rosa |
| author2 | Von Pressentin, Klaus |
| author_browse | Jansen, Rosa Von Pressentin, Klaus |
| author_facet | Von Pressentin, Klaus Jansen, Rosa |
| author_sort | Jansen, Rosa |
| collection | Thesis |
| description | Background Diabetes mellitus contributes considerably to morbidity and mortality. By analysing a South African cohort with diabetes-related adverse outcomes, the researchers felt that reviewing their past primary care may reveal contributing factors resulting in these outcomes. Methods A retrospective cohort design was used. Data from an existing district-level hospital database of referrals to intermediate care were analysed, focusing on diabetic adult patients referred between 1 November 2020 and 31 August 2021. Additional data were collected on the standard of primary care, investigations performed on admission and patient demise within 12 months of the research window. Results The cohort comprised 188 patients. The mean age was 64.4 years, 113 (60.1%) were female, and 98.1% had low socioeconomic status. The majority were admitted with strokes 130 (69.2%) and 139 (73.9%) were referred for intense short-term rehabilitation. A quarter of patients were newly diagnosed diabetics at admission. Of known diabetics, 44 (30.8%) had no HbA1c in the preceding two years. ACE-inhibitors were not prescribed adequately, and insulin initiation was delayed. Accessible data 12 months post review window revealed that 53 (28.2%) had demised and of those, 29 (54.7%) had demised within a month of initial admission. Conclusion Diabetic screening and management in primary care need improvement. It appears that guidelines were not followed adequately and potentially may have contributed to the outcomes experienced by this cohort, as well as subsequent costs to the health system. Contribution The authors recommend that barriers to following primary care diabetes guidelines be explored further in future research. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/39499 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:33:23.204Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2024 |
| publishDateRange | 2024 |
| publishDateSort | 2024 |
| publisher | Department of Public Health and Family Medicine |
| publisherStr | Department of Public Health and Family Medicine |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/39499 District Level Hospital Diabetic Patients Referred to Intermediate Care: A Descriptive Analysis Jansen, Rosa Von Pressentin, Klaus Family Medicine Background Diabetes mellitus contributes considerably to morbidity and mortality. By analysing a South African cohort with diabetes-related adverse outcomes, the researchers felt that reviewing their past primary care may reveal contributing factors resulting in these outcomes. Methods A retrospective cohort design was used. Data from an existing district-level hospital database of referrals to intermediate care were analysed, focusing on diabetic adult patients referred between 1 November 2020 and 31 August 2021. Additional data were collected on the standard of primary care, investigations performed on admission and patient demise within 12 months of the research window. Results The cohort comprised 188 patients. The mean age was 64.4 years, 113 (60.1%) were female, and 98.1% had low socioeconomic status. The majority were admitted with strokes 130 (69.2%) and 139 (73.9%) were referred for intense short-term rehabilitation. A quarter of patients were newly diagnosed diabetics at admission. Of known diabetics, 44 (30.8%) had no HbA1c in the preceding two years. ACE-inhibitors were not prescribed adequately, and insulin initiation was delayed. Accessible data 12 months post review window revealed that 53 (28.2%) had demised and of those, 29 (54.7%) had demised within a month of initial admission. Conclusion Diabetic screening and management in primary care need improvement. It appears that guidelines were not followed adequately and potentially may have contributed to the outcomes experienced by this cohort, as well as subsequent costs to the health system. Contribution The authors recommend that barriers to following primary care diabetes guidelines be explored further in future research. 2024-04-30T12:23:52Z 2024-04-30T12:23:52Z 2023 2024-04-30T08:21:28Z Thesis / Dissertation Masters MMed http://hdl.handle.net/11427/39499 eng application/pdf Department of Public Health and Family Medicine Faculty of Health Sciences |
| spellingShingle | Family Medicine Jansen, Rosa District Level Hospital Diabetic Patients Referred to Intermediate Care: A Descriptive Analysis |
| thesis_degree_str | Master's |
| title | District Level Hospital Diabetic Patients Referred to Intermediate Care: A Descriptive Analysis |
| title_full | District Level Hospital Diabetic Patients Referred to Intermediate Care: A Descriptive Analysis |
| title_fullStr | District Level Hospital Diabetic Patients Referred to Intermediate Care: A Descriptive Analysis |
| title_full_unstemmed | District Level Hospital Diabetic Patients Referred to Intermediate Care: A Descriptive Analysis |
| title_short | District Level Hospital Diabetic Patients Referred to Intermediate Care: A Descriptive Analysis |
| title_sort | district level hospital diabetic patients referred to intermediate care a descriptive analysis |
| topic | Family Medicine |
| url | http://hdl.handle.net/11427/39499 |
| work_keys_str_mv | AT jansenrosa districtlevelhospitaldiabeticpatientsreferredtointermediatecareadescriptiveanalysis |