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Article

Effects of Point-Of-Care Testing in General Practice for Type 2 Diabetes Patients on Ambulatory Visits and Hospitalizations

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DaCHE, Department of Public Health, Faculty of Health Sciences, University of Southern Denmark, J.B. Winsløw vej 9, 5000 Odense C, Denmark
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Research Unit of General Practice, Faculty of Health Science, University of Southern Denmark, J.B. Winsløw vej 9, 5000 Odense C, Denmark
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(17), 6185; https://doi.org/10.3390/ijerph17176185
Received: 17 June 2020 / Revised: 13 August 2020 / Accepted: 21 August 2020 / Published: 26 August 2020
(This article belongs to the Collection Health Care and Diabetes)
Point-of-care testing (POCT) of HbA1c means instant test results and more coherent counseling that is expected to improve diabetes management and affect ambulatory visits and hospitalizations. From late 2008, POCT has been implemented and adopted by a segment of the general practices in the capital region of Denmark. The aim of this study is to assess whether the introduction of POCT of HbA1c in general practice (GP) has affected patient outcomes for T2 diabetes patients in terms of hospital activity. We apply difference-in-differences models at the GP clinic level to assess the casual effects of POCT on the following hospital outcomes: (1) admissions for diabetes, (2) admissions for ambulatory care sensitive diabetes conditions (ACSCs), (3) ambulatory visits for diabetes. The use of POCT is remunerated by a fee, and registration of this fee is used to measure the GP’s use of POCT. The control group includes clinics from the same region that did not use POCT. The sensitivity of our results is assessed by an event study approach and a range of robustness tests. The panel data set includes 553 GP clinics and approximately 30,000 diabetes patients from the capital region of Denmark, observed in the years 2004–2012. We find that voluntary adoption of POCT of HbA1c in GP has no effect on hospital admissions and diabetes-related hospital ambulatory visits. Event study analysis and different treatment definitions confirm the robustness of these results. If implementation of POCT of HbA1c improves other parts of diabetes management as indicated in the literature, it seems worthwhile to implement POCT of HbA1c in the capital region of Denmark. However, doubts around the quality of POCT of HbA1c testing and a desire to capture data at central labs may prevent implementation of more value based HbA1c testing. View Full-Text
Keywords: point-of-care testing (POCT); diabetes; general practice; HbA1c; patient data; hospital admissions; ambulatory visits; difference-in-differences (DID) models; event study analysis point-of-care testing (POCT); diabetes; general practice; HbA1c; patient data; hospital admissions; ambulatory visits; difference-in-differences (DID) models; event study analysis
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MDPI and ACS Style

Kristensen, T.; Rose-Olsen, K.; Volmar Skovsgaard, C. Effects of Point-Of-Care Testing in General Practice for Type 2 Diabetes Patients on Ambulatory Visits and Hospitalizations. Int. J. Environ. Res. Public Health 2020, 17, 6185. https://doi.org/10.3390/ijerph17176185

AMA Style

Kristensen T, Rose-Olsen K, Volmar Skovsgaard C. Effects of Point-Of-Care Testing in General Practice for Type 2 Diabetes Patients on Ambulatory Visits and Hospitalizations. International Journal of Environmental Research and Public Health. 2020; 17(17):6185. https://doi.org/10.3390/ijerph17176185

Chicago/Turabian Style

Kristensen, Troels; Rose-Olsen, Kim; Volmar Skovsgaard, Christian. 2020. "Effects of Point-Of-Care Testing in General Practice for Type 2 Diabetes Patients on Ambulatory Visits and Hospitalizations" Int. J. Environ. Res. Public Health 17, no. 17: 6185. https://doi.org/10.3390/ijerph17176185

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