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Diabetes care by general practitioners in South Auckland: changes from 1990 to 1999
Tim Kenealy1, Helen Kenealy, Bruce Arroll
1Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand. t.kenealy@auckland.ac.nz.
Aim:
To compare self-reported practices and preferences for diabetes care by general practitioners (GPs) in South Auckland between 1990 and 1999.
Methods:
Mail questionnaires were sent to all GPs in South Auckland in 1990, and again in 1999.
Results:
The response rate was 88% (163/185) in 1990 and 76% (186/245) in 1999 (p = 0.3). In 1999, compared with 1990, GPs had more diabetic patients (median 33 vs 20, p <0.001), more GPs screened for diabetes using a fasting laboratory glucose (33.6% vs 22.9%, p = 0.04), more screened with capillary whole-blood testing meters (19.5% vs 1.3%, p <0.001), more felt confident to detect complications (95.1% vs 84.3%, p 0.001) and probably more felt confident to initiate insulin in Type 2 diabetes. Women in both years, compared with male GPs, were more likely to refer newly diagnosed diabetic patients to secondary services (68.0% vs 42.8%, p <0.001) and more likely to prefer 'shared care' for ongoing care (74.7% vs 58.7%, p = 0.007).
Conclusions:
There have been large changes in GP diabetes care in South Auckland from 1990 to 1999. GPs in 1999 seem more confident to care for larger numbers of diabetes patients. Significant differences in practice style exist between male and female GPs.