Establishment of pediatric diabetes network in Ontario has improved outcomes for children with diabetes, particularly those of low socioeconomic status
The establishment of a pediatric diabetes network in Ontario is associated with better health outcomes for children with diabetes, particularly children of low socioeconomic status, according to a new study conducted at the Institute for Clinical Evaluative Sciences (ICES).
“Our study found that through improved access to multidisciplinary specialized diabetes care, children with diabetes had fewer emergency department visits and hospitalizations,” says Dr. Astrid Guttmann, senior author on the study, chief science officer at ICES and a pediatrician and senior associate scientist at The Hospital for Sick Children.
Type 1 diabetes in children is increasing at a rate of three to five per cent per year worldwide. Serious complications, such as diabetic ketoacidosis and severe low blood sugar remain the leading cause of avoidable hospitalizations and emergency department (ED) visits among children with type 1 diabetes.
The system in Ontario is an organized provincial diabetes care network with 35 specialized pediatric diabetes programs. Each provides access to a multidisciplinary team consisting of diabetes physicians, nurses, dietitians and social workers who provide routine, preventive care for children with diabetes and have backup from centers with subspecialist pediatric endocrinologists.
In the study, published today in CMAJ Open, the researchers examined for the first time, how the implementation in 2001 of the Network of Ontario Pediatric Diabetes Programs affected care for children with diabetes and found:
- Lower ED and hospital admission rates overall post-implementation
- Narrowing of socioeconomic status gradients in ED visits and admissions for poor disease control post-implementation
- Rural residence was associated with higher risk of ED-visits post-implementation
“Our findings show that improved access to specialized diabetes care through the establishment of a diabetes network is associated with better health outcomes, particularly for those of lower socioeconomic status. But more work is needed to address the health care needs of those in rural areas,” says Dr. Meranda Nakhla, co-author on the study who is a pediatric endocrinologist at Montreal Children’s Hospital of the MUHC and a scientist at the Research Institute of the MUHC.
“Outcomes associated with a pediatric clinical diabetes network in Ontario: a population-based time-trend analysis,” was published today in CMAJ Open
Author block: Nakhla M, Rahme E, Simard M, Guttmann A.
The Institute for Clinical Evaluative Sciences (ICES) is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of health care issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting health care needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy. For the latest ICES news, follow us on Twitter: @ICESOntario
The Research Institute of the McGill University Health Centre (RI-MUHC) is a world-renowned biomedical and healthcare research centre. The Institute, which is affiliated with the Faculty of Medicine of McGill University, is the research arm of the McGill University Health Centre (MUHC) – an academic health centre located in Montreal, Canada, that has a mandate to focus on complex care within its community. The RI-MUHC supports over 460 researchers and close to 1,300 research trainees devoted to a broad spectrum of fundamental, clinical and health outcomes research at the Glen and the Montreal General Hospital sites of the MUHC. Its research facilities offer a dynamic multidisciplinary environment that fosters collaboration and leverages discovery aimed at improving the health of individual patients across their lifespan. The RI-MUHC is supported in part by the Fonds de recherche du Québec – Santé (FRQS). www.rimuhc.ca
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