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- W2064366317 abstract "Failure of access to structured diabetes care is associated with adverse outcome. There is no known validated data tool to identify access failure and thus we have developed a Failed Access Score (FAS) and have examined its associations.The FAS is part of the WICKED project (Wolverhampton Interface Care, Knowledge Empowered Diabetes), and consists of three key care processes in diabetes: namely HbA1c, urinary albumin:creatinine ratio and retinal screening. A retrospective case control study in a single GP practice was undertaken on all the patients (n=478) failing two or more parameters over 15 months. They were compared to those with no access failure matched for age, gender, ethnicity and type of diabetes.Among the 51 cases with a FAS ≥2, two or three process measures were absent in 84% and 16% respectively. Excluding service failure, this was due to non-attendance in 35% but otherwise associated with other clinical constraints in 41% (mental health, house bound, palliative care, multi-morbidity) and their deprivation index was significantly higher (p<0.01). Extrapolating to the whole health economy (n=16 644), 2362 (14%) would have a FAS of ≥2 of whom 968 (6%) would have failed access in association with these constraints.In conclusion, it is possible to identify people who are failing access to structured diabetes care using readily available data calculated as the FAS score. Failed access is not usually due to patient default or disengagement but rather, in almost 65%, either due to significant clinical disadvantage or pure failure of service. Copyright © 2014 John Wiley & Sons." @default.
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- W2064366317 date "2014-04-01" @default.
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- W2064366317 title "A case control study of use of the Failed Access Score for determination of failed access to structured diabetes care: the WICKED project" @default.
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- W2064366317 doi "https://doi.org/10.1002/pdi.1843" @default.
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