New research has found significant care gaps in follow-up of newly diagnosed diabetes patients.
Referrals for patients with newly-diagnosed diabetes have been put under the microscope in new research from the University of Sydney which examined uptake of Medicare-funded allied health services.
The study highlighted a crucial information gap in chronic condition care, with reports of widespread underutilisation of pre-existing services within the first two years of diagnosis.
“Our research shows there is very substantial underuse of those lifestyle and self-management support services,” said lead researcher Emma Cox.
“What that is pointing to is a lack of referral to these services by GPs.
“We’re recommending … GPs to be better educated around the value of these services, and for early referral to these services to be mandated.”
Barriers to referrals were identified as a combination of systemic failures and a lack of patient awareness.
“What has emerged from those is that there is a high administrative burden associated with care planning, and that is one barrier that GPs are facing around referring patients to allied health services,” Ms Cox said.
“The government has just made some changes under the new Strengthening Medicare reforms, and they’ve consolidated this process to try and streamline referrals to allied health.
“But this isn’t the only barrier, so the other strategies are needed as well to help increase use of these services.
“One of those main barriers is the out-of-pocket costs for those services.
“We’re recommending an increase in the Medicare rebate for allied health services, and that’s going to help reduce that out-of-pocket cost and make it more financially viable for allied health professionals to deliver the service.”
The study found current referral rates did not align with type 2 diabetes management guidelines.
Only 16.9% of newly diagnosed patients included in the study had accessed a Medicare-funded dietitian, whilst just 6% accessed a CDE or exercise physiologist within the first two years post diagnosis.
Dietitians have also expressed a reluctance to accept referrals because current Medicare rebates only cover consultations that are too short to properly address patent needs, according to the study.
“A noted limitation of the study was that it was not able to investigate privately funded services, prompting the need for further research to obtain a more comprehensive scope of the issue.
“This study couldn’t necessarily determine whether someone had been referred to allied health and then not used the service, or if they just hadn’t had any Allied Health Service use,” researcher and study co-author Dr Gideon Meyerowitz-Katz said.
“Only 67% of the people with diabetes had a GP management plan.
“Why that’s less than 100% and why it is so much lower for some of the key types of allied health service utilisation that we would look for is hard to say.”
