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Effectiveness of integrated care model for type 2 diabetes: A population-based study in Reggio Emilia (Italy)

AIMS: To compare the effectiveness of integrated care with that of the diabetes clinic care model in terms of mortality and hospitalisation of type 2 diabetes patients with low risk of complications. METHODS: Out of 27234 people with type 2 diabetes residing in the province of Reggio Emilia on 31/12...

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Autores principales: Ballotari, Paola, Venturelli, Francesco, Manicardi, Valeria, Ferrari, Francesca, Vicentini, Massimo, Greci, Marina, Pignatti, Fabio, Storani, Simone, Giorgi Rossi, Paolo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5870991/
https://www.ncbi.nlm.nih.gov/pubmed/29584749
http://dx.doi.org/10.1371/journal.pone.0194784
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author Ballotari, Paola
Venturelli, Francesco
Manicardi, Valeria
Ferrari, Francesca
Vicentini, Massimo
Greci, Marina
Pignatti, Fabio
Storani, Simone
Giorgi Rossi, Paolo
author_facet Ballotari, Paola
Venturelli, Francesco
Manicardi, Valeria
Ferrari, Francesca
Vicentini, Massimo
Greci, Marina
Pignatti, Fabio
Storani, Simone
Giorgi Rossi, Paolo
author_sort Ballotari, Paola
collection PubMed
description AIMS: To compare the effectiveness of integrated care with that of the diabetes clinic care model in terms of mortality and hospitalisation of type 2 diabetes patients with low risk of complications. METHODS: Out of 27234 people with type 2 diabetes residing in the province of Reggio Emilia on 31/12/2011, 3071 were included in this cohort study as eligible for integrated care (i.e., low risk of complications) and cared for with the same care model for at least two years. These patients were followed up from 2012 to 2016, for all-cause and diabetes-related mortality and hospital admissions. We performed a Poisson regression model, using the proportion of eligible patients included in the integrated care model for each general practitioner as an instrumental variable. RESULTS: 1700 patients were cared for by integrated care and 1371 by diabetes clinics. Mortality rate ratios were 0.83 (95%CI 0.60–1.13) and 0.95 (95%CI 0.54–1.70) for all-cause and cardiovascular mortality, respectively, and incidence rate ratios were 0.90 (95%CI 0.76–1.06) and 0.91 (95%CI 0.69–1.20) for all-cause and cardiovascular disease hospitalisation, respectively. CONCLUSION: For low risk patients with type 2 diabetes, the integrated care model involving both general practitioner and diabetes clinic professionals showed similar mortality and hospitalisation as a model with higher use of specialized care in an exclusively diabetes clinic setting.
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spelling pubmed-58709912018-04-06 Effectiveness of integrated care model for type 2 diabetes: A population-based study in Reggio Emilia (Italy) Ballotari, Paola Venturelli, Francesco Manicardi, Valeria Ferrari, Francesca Vicentini, Massimo Greci, Marina Pignatti, Fabio Storani, Simone Giorgi Rossi, Paolo PLoS One Research Article AIMS: To compare the effectiveness of integrated care with that of the diabetes clinic care model in terms of mortality and hospitalisation of type 2 diabetes patients with low risk of complications. METHODS: Out of 27234 people with type 2 diabetes residing in the province of Reggio Emilia on 31/12/2011, 3071 were included in this cohort study as eligible for integrated care (i.e., low risk of complications) and cared for with the same care model for at least two years. These patients were followed up from 2012 to 2016, for all-cause and diabetes-related mortality and hospital admissions. We performed a Poisson regression model, using the proportion of eligible patients included in the integrated care model for each general practitioner as an instrumental variable. RESULTS: 1700 patients were cared for by integrated care and 1371 by diabetes clinics. Mortality rate ratios were 0.83 (95%CI 0.60–1.13) and 0.95 (95%CI 0.54–1.70) for all-cause and cardiovascular mortality, respectively, and incidence rate ratios were 0.90 (95%CI 0.76–1.06) and 0.91 (95%CI 0.69–1.20) for all-cause and cardiovascular disease hospitalisation, respectively. CONCLUSION: For low risk patients with type 2 diabetes, the integrated care model involving both general practitioner and diabetes clinic professionals showed similar mortality and hospitalisation as a model with higher use of specialized care in an exclusively diabetes clinic setting. Public Library of Science 2018-03-27 /pmc/articles/PMC5870991/ /pubmed/29584749 http://dx.doi.org/10.1371/journal.pone.0194784 Text en © 2018 Ballotari et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Ballotari, Paola
Venturelli, Francesco
Manicardi, Valeria
Ferrari, Francesca
Vicentini, Massimo
Greci, Marina
Pignatti, Fabio
Storani, Simone
Giorgi Rossi, Paolo
Effectiveness of integrated care model for type 2 diabetes: A population-based study in Reggio Emilia (Italy)
title Effectiveness of integrated care model for type 2 diabetes: A population-based study in Reggio Emilia (Italy)
title_full Effectiveness of integrated care model for type 2 diabetes: A population-based study in Reggio Emilia (Italy)
title_fullStr Effectiveness of integrated care model for type 2 diabetes: A population-based study in Reggio Emilia (Italy)
title_full_unstemmed Effectiveness of integrated care model for type 2 diabetes: A population-based study in Reggio Emilia (Italy)
title_short Effectiveness of integrated care model for type 2 diabetes: A population-based study in Reggio Emilia (Italy)
title_sort effectiveness of integrated care model for type 2 diabetes: a population-based study in reggio emilia (italy)
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5870991/
https://www.ncbi.nlm.nih.gov/pubmed/29584749
http://dx.doi.org/10.1371/journal.pone.0194784
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