Short Communication
Diabetes and the use of primary care provider services in rural, remote and metropolitan Australia
AUTHORS
Soumya Mazumdar1 PhD, Adjunct Senior Lecturer and Epidemiologist *
Nasser Bagheri2 PhD, Senior Research Fellow 
Shanley Chong3 PhD, Adjunct Senior Lecturer and Biostatistician
Ian S McRae4 PhD, Visiting Fellow
Bin Jalaludin5 FAFPHM, PhD, Manager
Federico Girosi6 PhD, Professor
AFFILIATIONS
1 South Western Sydney Medical School, University of New South Wales, NSW 2170, Australia; and Population Health Intelligence, South Western Sydney Local Health District, Liverpool, NSW 1871, Australia
2 College of Health and Medicine, Australian National University, Canberra, ACT 0200, Australia
3 Population Health Intelligence, South Western Sydney Local Health District, Liverpool, NSW 1871, Australia and South Western Sydney Medical School, University of New South Wales, NSW 2170, Australia
4 Department of Health Services Research & Policy, Australian National University, Canberra, ACT 0200, Australia
5 Population Health Intelligence, South Western Sydney Local Health District, Liverpool, NSW 1871, Australia
6 Translational Health Research Institute, Western Sydney University, Campbelltown, NSW 2560, Australia
ACCEPTED: 20 May 2021
early abstract:
Introduction: Public health agencies around the world are concerned about an ever increasing burden of type 2 diabetes and related disability. Access to primary care providers (PCPs) can support early diagnosis and management. However, there is limited literature on how frequently older people with diabetes access PCPs, and their levels of access in rural Australia relative to metropolitan areas.
Methods: In this research paper patterns of PCP use amongst those with diagnosed diabetes and those without diagnosed diabetes (referred to as “healthy” individuals) were compared using a large survey of over 230,000 people aged 45 years and older from New South Wales, Australia. A published model to study the PCP access patterns of a group of individuals with diabetes risk was used.
Results: We found that annual visits to PCPs among 45 and older people with diabetes in rural areas, while higher than healthy rural residents, were significantly lower than their metropolitan counterparts, mirroring similar disparities in PCP use across the rural-urban divide in the healthy population. Similar patterns were also present in the high risk population. Nevertheless, people with diabetes visited PCPs around four times a year, which is around the recommended number of annual visits, though some groups (e.g. those with other comorbid conditions) may need more visits.
Conclusions: Patterns of PCP use among rural residents, while significantly less frequent than their metropolitan counterparts, are at the recommended level for people with diabetes.