Contextualizing the Effectiveness of a Collaborative Care Model for Diabetes and Depression in Primary Care: A Qualitative Assessment

Abstract

s / Can J Diabetes 38 (2014) S29eS74 S33 hyperglycemia. The clinic accepted eligible patients from throughout the hospital, with a focus on the emergency department and cancer program. We conducted an evaluative study of the RADAR clinic’s impact on care delivery and resource utilization. Patients seen by Sunnybrook endocrinologists between January and May 2012 who would have been eligible for the RADAR clinic were compared with those seen in the RADAR clinic after its opening until July 2013. For each group, we calculated the mean wait time from referral to visit, and the proportion of patients whose care was coordinated between the endocrinologist and the diabetes education team. In addition, to determine the clinic’s impact on hospital inpatient resource utilization, the mean length of stay for cancer program patients hospitalized for hyperglycemia was calculated quarterly from 2011/12 Q1 to 2013/14 Q3. Themeanwait time for urgent diabetes referrals was 59 days prior to the implementation of the RADAR clinic, and 4 days afterwards. The proportion of patients receiving coordinated interdisciplinary care increased from 62% with baseline “usual” care to 100% with the RADAR clinic. Lengths of hospital stay for hyperglycemia among cancer program patients declined (Figure 1, page S32). The implementation of the RADAR clinic was associated with faster access to care for complex diabetes patients with uncontrolled hyperglycemia, improved delivery of interdisciplinary care and shorter lengths of hospital stay.