6. Discussion
Our study provides the first estimate of the extent and
direct costs of community nursing for supporting patients
with type 2 diabetes in an urban Australian setting. During
an average 8.6 years of follow up, almost 30% of our sample
received treatment from the community nursing service
and the majority received a substantial number of visits.
However, the range was large and some patients received
nurse visits for a prolonged time period. Not surprisingly,
the estimated cost was also high and the per patient cost
varied considerably. When extrapolated to the Australian
diabetes community, community nursing was estimated to
cost an additional A$53 million annually to the health
service. Community nursing is likely to confer many
benefits including cost savings e.g. by preventing or
delaying the need for hospitalisation or expensive residential
care. Given that our cost estimates are conservative,
there is a need for more research into the current and
potential effectiveness of home nursing in the management
of type 2 diabetes