ArticleJournal of the Royal Society of Medicine2021
Associations between attainment of incentivised primary care indicators and emergency hospital admissions among type 2 diabetes patients: a population-based historical cohort study.
Article in Journal of the Royal Society of Medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Banting memorial lecture 2025: Aligning clinical practice, policy and research.Diabetic medicine : a journal of the British Diabetic Association · 2026Article
- Trend and quality of care for diabetic patients in diabetes outpatient clinics before and during the COVID-19 pandemic.BMC health services research · 2025Article
- Chronic care provision in general practices and association with patient level outcomes: a nationwide cohort study.BMC medicine · 2025Article
- Patient-level factors associated with hemoglobin A1C testing in Alabama Medicaid beneficiaries with diabetes.Primary care diabetes · 2023Article
- Article
- The impact of the COVID-19 pandemic on diabetes services: planning for a global recovery.The lancet. Diabetes & endocrinology · 2022Review
- Trends in leading causes of hospitalisation of adults with diabetes in England from 2003 to 2018: an epidemiological analysis of linked primary care records.The lancet. Diabetes & endocrinology · 2022Article
- COVID-19: the silenced voices of the pandemic that must be heard.Journal of the Royal Society of Medicine · 2021Article
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Authors and funding
7 authors.
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Abstract
objectivesEngland has invested considerably in diabetes care over recent years through programmes such as the Quality and Outcomes Framework and National Diabetes Audit. However, associations between specific programme indicators and key clinical endpoints, such as emergency hospital admissions, remain unclear. We aimed to examine whether attainment of Quality and Outcomes Framework and National Diabetes Audit primary care diabetes indicators is associated with diabetes-related, cardiovascular, and all-cause emergency hospital admissions.
designHistorical cohort study.
settingA total of 330 English primary care practices, 2010-2017, using UK Clinical Practice Research Datalink.
participantsA total of 84,441 adults with type 2 diabetes.
main outcome measuresThe primary outcome was emergency hospital admission for any cause. Secondary outcomes were (1) diabetes-related and (2) cardiovascular-related emergency admission.
resultsThere were 130,709 all-cause emergency admissions, 115,425 diabetes-related admissions and 105,191 cardiovascular admissions, corresponding to unplanned admission rates of 402, 355 and 323 per 1000 patient-years, respectively. All-cause hospital admission rates were lower among those who met HbA1c and cholesterol indicators (incidence rate ratio = 0.91; 95% CI 0.89-0.92;
conclusionsAttaining Quality and Outcomes Framework-defined diabetes intermediate outcome thresholds, and comprehensive completion of care processes, may translate into considerable reductions in emergency hospital admissions. Out-of-hospital diabetes care optimisation is needed to improve implementation of core interventions and reduce unplanned admissions.
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