Related Experiment Videos
Resources and population served: a description of the Ontario Paediatric Diabetes Network
Rayzel Shulman1, Fiona A Miller1, Therese A Stukel1
1Department of Pediatrics (Shulman, Daneman, Guttmann), The Hospital for Sick Children, University of Toronto; Institute of Health Policy, Management and Evaluation (Shulman, Miller, Stukel, Guttmann), University of Toronto; Institute for Clinical Evaluative Sciences (Shulman, Stukel, Guttmann); Toronto Health Economics and Technology Assessment (THETA) Collaborative (Miller), University of Toronto, Toronto, Ont.
Insights
Pediatric diabetes care in Ontario shows significant variation in insulin pump use and access to specialized resources across centers. Further research is needed to understand the impact on patient outcomes.
Area of Science:
- Pediatric Endocrinology
- Health Services Research
- Diabetes Technology
Background:
- The Ontario Paediatric Diabetes Network was established to improve specialized pediatric diabetes care.
- Universal funding for insulin pump therapy has been available in Ontario since 2006.
- This study examines patient distribution, resources, and insulin pump utilization across network centers.
Purpose of the Study:
- To describe the distribution of pediatric diabetes patients, resources, and insulin pump use across centers in the Ontario Paediatric Diabetes Network.
- To assess variations in specialized care access and technology uptake.
Main Methods:
- A 2012 cross-sectional survey of 35 pediatric diabetes centers in Ontario.
- Data collected on center characteristics, patient volume, and clinical/social resources.
- Provincial health administrative data used to determine insulin pump usage in patients aged 18 and under.
Main Results:
- All 35 centers participated, reporting 6676 children with type 1 diabetes and 368 with type 2 diabetes.
- Insulin pump use averaged 38.1% but varied significantly (5.3%-66.7%) across centers.
- Access to funded 24-hour support for pump users was inconsistent across different center types.
Conclusions:
- Significant differences exist in access to specialized and after-hours care for children with diabetes in Ontario.
- Wide variations in insulin pump utilization highlight potential disparities in care.
- Further investigation is required to determine the impact of these variations on the quality of care and patient outcomes.
Background:
The Network of Ontario Pediatric Diabetes Programs was established in 2001 to provide access to specialized pediatric diabetes care. Universal funding for pediatric insulin pump therapy has been available in Ontario since 2006. The objective of this study was to describe the distribution of patients, resources and insulin pump use across centres within the network, now called the Ontario Paediatric Diabetes Network.
Methods:
We conducted a cross-sectional survey in 2012 of the 35 pediatric diabetes centres in Ontario to measure centre characteristics, patient volume and available clinical and social resources. We used health administrative data from the provincial Assistive Devices Program to describe patients aged 18 years or less using insulin pumps by centre as a measure of technology uptake.
Results:
All 35 centres participated, reporting a total of 6676 children with type 1 diabetes and 368 with type 2 diabetes. Most (> 80%) children with type 1 diabetes were followed at tertiary (n = 5) or large community (n = 14) centres. Nursing patient load was similar between centre types, but there was a large range across centres within any type. Overall, percent insulin pump use was 38.1% and varied widely across centres (5.3%-66.7%). Funded 24-hour support for pump users was available at 5 (36%) small community centres, 3 (19%) large community centres and 2 (40%) tertiary centres.
Interpretation:
Our study showed differences in access to specialized and after-hours care for children with diabetes in Ontario. Pump use varied widely across centres. Further research is needed to assess the impact of these observed differences on quality of care and outcomes.