THE NEW ZEALAND MEDICAL JOURNAL Journal of the New Zealand Medical Association NZMJ 14 March 2008, Vol 121 No 1270; ISSN 1175 8716 URL: http://www.nzma.org.nz/journal/121-1270/2945/ ©NZMA Page 35 Retention of patients in the Get Checked free annual diabetes review programme in New Zealand Grace Joshy, Ross A Lawrenson, David Simmons Abstract Aims To characterise the retention of patients in the Get Checked free annual diabetes review programme in the Waikato region of New Zealand. Methods Retrospective review of Waikato Primary Health (WPH) registered patients who had at least one Get Checked review between 1 July 2000 and 30 Jun 2006. Results 10,919 patients (69% Europeans, 18% Māori, 3% Pacific Islanders, and 4% Asian) had an initial review during the 5 years of this programme. In 2005/06, only 6100 (57%) of the estimated 10,600 diabetes patients enrolled with WPH utilised the free check. Younger patients aged <40 years, those of Māori or Asian origin, and those with Type 1 diabetes were less likely to be retained in the programme with regular checks, as indicated by their longer time to second review and lesser likelihood of return for a second or subsequent review. Conclusions Despite the programme being fully funded, a significant proportion of patients did not return for a second review within 1.5 years after initial review. The loss of those with Type 1 diabetes and younger patients may reflect their greater contact with secondary care rather than GP services. Excess drop out among ethnic minorities need further investigation and intervention. Use of these data for policy purposes could be significantly biased unless there is a single reliable regional diabetes register based on the National Health Index number including all known patients. The rising diabetes epidemic is a major problem in New Zealand, especially among the non-European ethnic groups. 1 The cost of Type 2 diabetes alone is expected to reach NZD1.6 billion by year 2021. 2 Many of those with diabetes face a multitude of barriers to quality diabetes care and self care, 3,4 including financial barriers. 5 Structured care has been shown to improve patient care and outcomes. 6–8 One strategy used elsewhere to ensure that each person with diabetes received regular structured assessment has been the annual diabetes review. 9–11 The Get Checked free annual diabetes review programme in New Zealand—a Ministry of Health initiative which started in June 2000—was established to address both the need for structured care and to help overcome personal expenses as a barrier to diabetes care. This national programme is delivered free of charge to diabetes patients through primary care services. The review form collects data on whether the following checks or tests were either done or booked to be done: retinal screening (within the last 2 years), foot check, blood pressure, HBA 1c , cholesterol, height, bodyweight, and kidney function in the last 12 months. Available test results are also collected.