Does having a personal physician improve quality of care in diabetes? J Am Board Fam Med 2010;23(1):82-7
Date
01/07/2010Pubmed ID
20051546DOI
10.3122/jabfm.2010.01.090102Scopus ID
2-s2.0-74549160028 (requires institutional sign-in at Scopus site) 22 CitationsAbstract
PURPOSE: Although having a continuous relationship with a physician is a defining feature of primary care, few studies have evaluated the effect of this on chronic disease management. This aim of this study was to examine whether having a regular physician is associated with improvements in reaching treatment goals for patients with diabetes.
METHODS: Through the use of a diabetes registry, patients diagnosed with diabetes mellitus for a minimum of 6 months cared for in a large, single academic family medicine practice were compared based on whether they had a regular physician or not. The 2 groups were compared in the frequency in which they achieved goals for management of glycated hemoglobin, blood pressure, low-density lipoprotein cholesterol, and other aspects of diabetes care.
RESULTS: Patients with a regular provider were slightly older than those without a provider (57.5 years vs. 50.9 years; P = .002), but the gender distribution and percent who were smokers was the same. In assessing diabetes quality measures, patients with a regular provider had lower average levels of glycated hemoglobin (7.70 vs 8.53; P = .01), but no difference was noted in the percentage achieving a goal of < or =7.0. No differences were noted between the groups in either the average systolic or diastolic blood pressures or low-density lipoprotein cholesterol or in the percentages of patients achieving recognized goals for these measures. When examining other preventive services, patients with a regular provider were more likely to receive an influenza immunization within the last year (51.8% vs 35.6%; P = .02) but no more likely to receive a pneumococcal vaccine or take an aspirin each day.
CONCLUSION: This study suggests that there are few benefits for patients with diabetes in having an established regular provider over having a regular place of service.
Author List
Hueston WJMESH terms used to index this publication - Major topics in bold
AdultAged
Blood Pressure
Cholesterol, LDL
Continuity of Patient Care
Diabetes Mellitus, Type 2
Family Practice
Female
Group Practice
Health Services Accessibility
Humans
Male
Middle Aged
Patient Compliance
Personal Health Services
Physician-Patient Relations
Population Surveillance
Quality Assurance, Health Care
Registries
Retrospective Studies
South Carolina
