Findings

Diabetes diagnosis was much more commonly first recorded in the GP record:

• 59% of people with diagnosis was first recorded at the GP.
• 37% of people with diagnosis was first recorded in hospital setting.
• 4% of people with diagnosis was first recorded in unknown setting.

Finding 1: Where diabetes diagnosis is first recorded varies by people’s characteristics, such as remoteness of residence:

• In GP settings: over half in cities or regional centres.
• In hospital settings: up to two thirds living in remote and very remote area.

Finding 2: Proactive care in the community was more common for people who had their first recorded diabetes diagnosis in the GP record (over 2 years study):

• In GP settings: 50% have antidiabetic medications prescribed; more likely to have GP management plans and reviews; More likely to have blood pressure, cholesterol and HbA1c recorded.
• In hospital settings: 27% have antidiabetic medications prescribed.

Finding 3: Presentation to hospital was less common among people who had their first recorded diabetes diagnosis in the GP record (over 2 years study):

• In GP settings: 16 GP visits; 2 emergency department presentations; 2 hospital admissions; 8 outpatient services.
• In hospital settings: 10 GP visits; 2 ermergency department presentations; 4 hospital admissions; 12 outpatient services.

Finding 4: Mortality was lower for people who had their first reported diagnosis in the GP record:

• In GP settings: 4% mortality across the study period.
• In hospital settings: 6% mortality across the study period.

About the study

• 470 practices, representing 17.6% of all NSW general practices provided data.
• 3,965,041 patients were included in the Lumos linkage, representing 48.5% of the NSW population.
• People aged 18 years or older, from Lumos participating GPs that contributed data to Lumos in October 2021, who had a diabetes diagnosis recorded in their GP or hospital records (1).
• 8.2% of people included in the Lumos data had a recorded diagnosis of diabetes, compared with an estimated 11% of the NSW adult population and 6.1% reported by the Australian Bureau of statistics (2), (3).
• Using Lumos data, dates of diabetes diagnoses were compared in GP and hospital records to determine which of these settings held the earliest record of diabetes diagnosis (1).

Notes

1. Diabetes diagnosis recorded in general practices that were not participating in the Lumos program will not be captured in this analysis.
   
2. 2019 prevalence rate for persons in NSW aged 16+ per NSW Population Health Survey and Evidence, NSW Ministry of Health
   
3. 2017-18 prevalence rate for persons in NSW aged 15+ per National Health Survey: First Results, 2017-18 – New South Wales. Source: Australian Bureau of Statistics

Background

Diabetes is a burdensome condition in NSW and management of diabetes is compounded by fragmentation in the current health system, particularly at primary and acute care system interfaces.

There have long been aspirations to understand the impact of primary care and its interactions with other health services. However, up until recently, attempts to assemble this information have been small scale.

The Lumos program links records from participating NSW general practices (GPs) to records held by NSW Health such as hospital admissions, emergency department and outpatient visits, and mortality.

This fact sheet provides information about diabetes in primary and acute care settings that is available in the Lumos data asset.