Location

Victoria South Ballroom, Ottawa Marriott Hotel

Event Website

http://sociology.uwo.ca/cluster/en/projects/knowledge_mobilization/2015/2015_conference/index.html#2015 Conference

Start Date

19-3-2015 12:30 PM

End Date

19-3-2015 12:45 PM

Description

Poster Presentation

Background: Family Medicine Groups (FMG) were introduced in Quebec in 2002 to reorganize primary care practices and encourage team-based and inter-professional approaches to service delivery. We measured the effect of this reform on the rate of emergency department (ED) visits among patients diagnosed with diabetes.

Methods: Administrative databases were used to derive the weekly rate of ED visits between April 1, 2000 and March 31, 2012. We performed an interrupted segmented regression analysis to derive the estimated and extrapolated rates of visits in the years following the initial reform implementation. We employed an outcome control series of diabetics visiting the ED to treat appendicitis to strengthen the study’s internal validity.

Results: A gradual decline in the rate of visits was observed for short term diabetes related complications and total ED visits. After 9 years of reform implementation, we observed a reduction of 1.42 and 1.70 ED visits per 10,000 diabetics to treat short term complications in urban and rural areas, respectively. A steady decrease was also observed in the total rate of ED visits in urban areas where we observed a reduction of 6.72 visits per 10,000 diabetics 9 years following the reform. Visits coded for appendicitis showed no clinically relevant changes over the study period.

Interpretation: Our results suggest that the decreases in the rate of ED visits are attributed to the implementation of the FMG model across the province. The steady decline in the rate of total ED visits in urban areas is of particular relevance where overutilization of the ED is a problem. Evidence of these decreases despite the low-intensity nature of the FMG reform suggests the potential for this model to act as a future platform for implementing comprehensive care models for chronic disease management.


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Mar 19th, 12:30 PM Mar 19th, 12:45 PM

Effect of Family Medicine Groups on Visits to the Emergency Department among Diabetics in Quebec between 2000 and 2011: A Population-Based Segmented Regression Analysis of an Interrupted Time Series

Victoria South Ballroom, Ottawa Marriott Hotel

Poster Presentation

Background: Family Medicine Groups (FMG) were introduced in Quebec in 2002 to reorganize primary care practices and encourage team-based and inter-professional approaches to service delivery. We measured the effect of this reform on the rate of emergency department (ED) visits among patients diagnosed with diabetes.

Methods: Administrative databases were used to derive the weekly rate of ED visits between April 1, 2000 and March 31, 2012. We performed an interrupted segmented regression analysis to derive the estimated and extrapolated rates of visits in the years following the initial reform implementation. We employed an outcome control series of diabetics visiting the ED to treat appendicitis to strengthen the study’s internal validity.

Results: A gradual decline in the rate of visits was observed for short term diabetes related complications and total ED visits. After 9 years of reform implementation, we observed a reduction of 1.42 and 1.70 ED visits per 10,000 diabetics to treat short term complications in urban and rural areas, respectively. A steady decrease was also observed in the total rate of ED visits in urban areas where we observed a reduction of 6.72 visits per 10,000 diabetics 9 years following the reform. Visits coded for appendicitis showed no clinically relevant changes over the study period.

Interpretation: Our results suggest that the decreases in the rate of ED visits are attributed to the implementation of the FMG model across the province. The steady decline in the rate of total ED visits in urban areas is of particular relevance where overutilization of the ED is a problem. Evidence of these decreases despite the low-intensity nature of the FMG reform suggests the potential for this model to act as a future platform for implementing comprehensive care models for chronic disease management.

https://ir.lib.uwo.ca/pclc_conf/2015/Day1/20

 

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