Article Text
Abstract
Background The dietitian-first gastroenterology clinic (DFGC) is an expanded scope of practice initiative implemented in response to increased gastroenterology specialist demand. This study examined re-referral rates to gastroenterology and overall health service usage up to 24 months post management in DFGC compared with a traditional, gastroenterology specialist-first model.
Methods Patients discharged from DFGC in the first year were matched with those seen in the traditional model. Demographic, clinical and process-related service characteristics were compared, and logistic regression analysis was undertaken to model re-presentation and model of care (MoC) as the variable of interest considering covariates in univariate analyses. Analyses were performed at 12, 18 and 24 months post discharge.
Results The DFGC (122 patients) and traditional-model (62 patients) cohorts had similar baseline demographic characteristics. Wait-times (68.6 vs 272.9 days; p<0.001), treatment-times (89.4 vs 259.9 days; p<0.001) and usage of other services (1.4 vs 2.1 specialities; p=0.01) were lower in DFGC. Re-referral rates were low in both DFGC and traditional models at 12 months (0.82% vs 1.61%), 18 months (2.46% vs 6.45%) and 24 months (4.91% vs 8.06%), respectively, with no significant difference between the models at any time point.
Conclusion Most patients do not re-present for similar conditions within 2 years when managed in the DFGC or traditional medical model. Patients managed in DFGC have lower overall health service usage compared with patients managed in the traditional model. These findings support the safety and effectiveness of a DFGC model as one strategy to manage specialist gastroenterology service demands.
- diet
- audit
- nutrition
- health service research
Data availability statement
All data relevant to the study are included in the article or uploaded as supplementary information. However, further information can be obtained from the corresponding author.
Statistics from Altmetric.com
Data availability statement
All data relevant to the study are included in the article or uploaded as supplementary information. However, further information can be obtained from the corresponding author.
Footnotes
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Contributors RC, RM, LB and RA devised the project devised the project, the main conceptual ideas and proof outline. RM and SO collated, analysed and interpreted the data and drafted the manuscript. All authors read and approved the final manuscript.
Funding This work was supported by the Allied Health Profession Office of Queensland (AHPOQ) Health Practitioner Research Scheme (grant number AH001649). Lauren Ball is supported by an NHMRC Investigator Grant (APP1173496).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.