Weber, HC and Robinson, PF and Saxby, N and Beggs, S and Els, IA and Ehrlich, RI, Do children with cystic fibrosis receiving outreach care have poorer clinical outcomes than those treated at a specialist cystic fibrosis centre?, Australian Journal of Rural Health, 25, (1) pp. 34-41. ISSN 1038-5282 (2017) [Refereed Article]
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© 2016 The Authors. Australian Journal of Rural Health published by John Wiley & Sons Australia, Ltd on behalf of National Rural Health Alliance. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) License, (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Introduction: Although cystic fibrosis (CF) centre care is generally considered ideal, children living in regional Australia receive outreach care supported by the academic CF centres..
Methods: This is a retrospective database review of children with CF treated at the Royal Children's Hospital in Melbourne and its outreach clinics in Albury (Victoria), and Tasmania. The aim was to compare the outcomes of children with CF managed at an academic centre with that of outreach care, using lung function, nutritional status and Pseudomonas aeruginosa colonisation. Three models of care, namely CF centre care, Shared care and predominantly Local care, were compared, based on the level of involvement of CF centre multidisciplinary team. In our analyses, we controlled for potential confounders, such as socio-economic status and the degree of remoteness, to determine its effect on the outcome measures..
Results There was no difference in lung function, i.e. forced expiratory volume in 1 s (FEV1), the prevalence of Pseudomonas aeruginosa colonisation or nutritional status (body mass index (BMI)) between those receiving CF centre care and various modes of outreach care. Neither socio-economic status, measured by the Socio-Economic Index for Area (SEIFA) for disadvantage, nor distance from an urban centre (Australian Standard for Geographical Classification (ASGC)) were associated with lung function and nutritional outcome measures. There was however an association between increased Pseudomonas aeruginosa colonisation and poorer socio-economic status..
Conclusion Outcomes in children with CF in regional and remote areas receiving outreach care supported by an academic CF centre were no different from children receiving CF centre care.
|Item Type:||Refereed Article|
|Keywords:||comparative study, cystic fibrosis, cystic fibrosis centre, outreach care, paediatric|
|Research Division:||Biomedical and Clinical Sciences|
|Research Group:||Clinical sciences|
|Research Field:||Rural clinical health|
|Objective Group:||Evaluation of health and support services|
|Objective Field:||Evaluation of health and support services not elsewhere classified|
|UTAS Author:||Weber, HC (Dr Heinrich Weber)|
|UTAS Author:||Saxby, N (Dr Nicole Saxby)|
|UTAS Author:||Beggs, S (Dr Sean Beggs)|
|UTAS Author:||Els, IA (Dr Ingrid Els)|
|Web of Science® Times Cited:||2|
|Deposited By:||Rural Clinical School|
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