In diabetes control, regular provider equals regular place of service

January 01, 0001

In diabetes control, regular provider equals regular place of service

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 by researchers from Charleston, South Carolina was to examine whether having a regular physician is associated with improvements in reaching treatment goals for patients with diabetes. 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. Patients with a regular provider were significantly slightly older than those without a provider (57.5 years vs. 50.9 years), but the gender distribution and percent who were smokers was the same.

In assessing diabetes quality measures, patients with a regular provider had significant lower average levels of glycated hemoglobin (7.70 vs 8.53), but no difference was noted in the percentage achieving a goal of =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 significantly more likely to receive an influenza immunization within the last year (51.8% vs 35.6%) but no more likely to receive a pneumococcal vaccine or take an aspirin each day.

The researchers concluded: "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."

This may be beneficial as the modern trend is for patients to seek out a medical practice rather than an individual practitioner.

For the full abstract, click here.

The Journal of the American Board of Family Medicine 23 (1): 82-87, January 2010 © 2010 American Board of Family Medicine
Does Having a Personal Physician Improve Quality of Care in Diabetes?. William J. Hueston. Correspondence to: William J. Hueston: [email protected]

Category: T. Endocrine/Metabolic/Nutritional, HSR. Health Services Research. Keywords: quality of care, personal physician, diabetes, registry, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 18 February 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.