ArticleBMC health services research2010
Primary care nurses: effects on secondary care referrals for diabetes.
Article in BMC health services research, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- Referral interventions from primary to specialist care: a systematic review of international evidence.The British journal of general practice : the journal of the Royal College of General Practitioners · 2014Pooled it
- Effects on HbA1c of referral of type 2 diabetes patients to secondary care.Scandinavian journal of primary health care · 2025Article
- Synergy of policies to strengthen primary care: evidence from a national repeated cross-sectional study.BMC health services research · 2020Article
- Effect of the economic crisis on the use of health and home care services among Spanish COPD patients.International journal of chronic obstructive pulmonary disease · 2018Article
- Impact of health workforce availability on health care seeking behavior of patients with diabetes mellitus in China.International journal for equity in health · 2017Article
- Potential for substitution of mental health care towards family practices: an observational study.BMC family practice · 2017Observational
- Consultations in general practices with and without mental health nurses: an observational study from 2010 to 2014.BMJ open · 2016Observational
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPrimary care nurses play an important role in diabetes care, and were introduced in GP-practice partly to shift care from hospital to primary care. The aim of this study was to assess whether the referral rate for hospital treatment for diabetes type II (T2DM) patients has changed with the introduction of primary care nurses, and whether these changes were related to the number of diabetes-related contacts in a general practice.
methodsHealthcare utilisation was assessed for a period of 365 days for 301 newly diagnosed and 2124 known T2DM patients in 2004 and 450 and 3226 patients in 2006 from general practices that participated in the Netherlands Information Network of General Practice (LINH). Multilevel logistic and linear regression analyses were used to analyse the effect of the introduction of primary care nurses on referrals to internists, ophthalmologists and cardiologists and diabetes-related contact rate. Separate analyses were conducted for newly diagnosed and known T2DM patients.
resultsReferrals to internists for newly diagnosed T2DM patients decreased between 2004 and 2006 (OR:0.44; 95%CI:0.22-0.87) in all practices. For known T2DM patients no overall decrease in referrals to internists was found, but practices with a primary care nurse had a lower trend (OR:0.59). The number of diabetes-related contacts did not differ between practices with and without primary care nurses. Cardiologists' and ophthalmologists' referral rate did not change.
conclusionsThe introduction of primary care nurses seems to have led to a shift of care from internists to primary care for known diabetes patients, while the diabetes-related contact rate seem to have remained unchanged.
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