Hospital visits reduced for diabetes

PHOTO: Hospital visits reduced for diabetes

Medical consultations and health screenings are scheduled on the same day, among other adjustments made by hospitals, to help patients save time. Joan Chew reports

A new clinic at the KK Women's and Children's Hospital (KKH) has halved yearly visits for young diabetic patients from eight to four.

In the past, patients not only had to visit the endocrinologist once every three months, they had to make another four visits if they had diabetes for more than five years, or were over 10 years old.

This is because they needed to go for yearly screening tests for complications such as diabetic retinopathy, an eye disease. They also had to see the dietitian and the medical social worker if they needed financial counselling.

Now, these extra four visits can be packed into one visit to the Diabetes Annual Review Clinic set up last July - bringing the total number of visits to just four a year.

Not only that, the clinic has made it so convenient that more diabetic patients now are able to complete their annual screening tests.

From July to December last year, 103 patients completed their annual screening tests, a 32-per-cent rise over the same period in 2013.

The new clinic allows patients to undergo their annual retinal eye screening there, instead of having to go to the hospital's eye centre.

A computerised retinal screening system, with software developed by the Singapore National Eye Centre (SNEC), makes it possible for doctors to send retinal images to SNEC for analysis, with the results returned to KKH on the same day.

This way, the results can be discussed with the patient and his parents within the day.

These annual screening tests are important to "optimise the growth, development, health and life expectancy of every child with diabetes", said Dr Lek Ngee, a consultant at the endrocrinology service at KKH.

PATIENTS SAVE TIME

Each year at KKH, about 60 children and adolescents aged under 16 are diagnosed with diabetes.

The hospital now has over 400 paediatric patients, with two-thirds having type 1 diabetes, in which a person does not produce insulin, a hormone that regulates blood sugar.

For parents like Ms Malarvizi Rengasamy, a 48-year-old childcare centre director, the new clinic has made things more convenient.

Both her children, age 15 and 10, have type 1 diabetes. In the past, she would take more than 10 days of leave a year to take them to their separate appointments.

Last September, she took them both to the new clinic to have their annual screening on the same day.

Although they were at the hospital for much of the day, they received their screening results that very day, so she did not need to fret.

HOSPITALS MAKE IMPROVEMENTS

Other hospitals are also working to bump up screening rates for diabetes-related complications.

Since 2013, staff at National University Hospital's diabetic clinic actively check outpatients' medical records so they can schedule their screenings on the same day as their doctor's appointment.

Now, an estimated 40 to 50 per cent of diabetic patients complete their eye and foot screening, double that from two years ago, said Associate Professor Tai E Shyong, head of endocrinology at NUH.

Meanwhile, Khoo Teck Puat Hospital's (KTPH) Diabetic Kidney Disease Clinic allows patients to see the endocrinologist and nephrologist at the same time, cutting down on their hospital trips.

Associate Professor Lim Su Chi, a senior consultant at KTPH's Diabetes Centre, said both specialists weigh in on the types and dosage of a patient's medication.

The hospital also has a bigger team running its Vascular Podiatry Clinic now, with three doctors and two podiatrists, up from one doctor and one podiatrist when it first started in May 2012.

At this clinic, podiatrists and vascular doctors work together to treat wounds which heal poorly due to blocked blood flow in the body, a common problem among diabetics.

This is because the clinic is handling more patients, where eight in 10 have diabetes, said KTPH's principal podiatrist Chelsea Law.

joanchew@sph.com.sg


This article was first published on Mar 26, 2015.
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