Point-of-care testing of HbA1c in diabetes care and preventable hospital admissions: Conference proceeding

Background: Point-of-care testing (POCT) of HbA1c may result in improved diabetic control, better patient outcomes and enhanced clinical efficiency with fewer patient visits and subsequent reductions in hospitalizations and costs. In 2008, the Danish regulators agreed to create a new tariff for the remuneration of POCT of HbA1c in primary care.

Aim: The aim of this study is to assess whether there is an association between the use of POCT of HbA1c and preventable hospital admissions among diabetes patients in general practice.

Method: We apply logistic regression analyses to examine whether there is a link between preventable hospital admissions and POCT of HbA1c in general practice. Preventable hospital admissions were assessed through the ambulatory care sensitive conditions (ACSCs) classification of hospital admissions. We include independent variables such as gender, age, ethnicity, socioeconomic covariates, municipality classifications and case mix measure in terms of the charlson index and costs of care in primary care and secondary care.

Results: There was a significant link between POCT of HbA1c among diabetes patients in general practice and an ACSC-measure of preventable out- and inpatient hospital treatment after adjusting for individual-level patient characteristics. However, the link was not significant when the measure of hospital treatment for ACSCs was restricted to inpatient treatment.

Conclusion: Our preliminary results indicate that more POCT of HbA1c may result in fewer preventable hospital treatments for ACSCs among diabetes patients in general practice.