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J Gen Intern Med. 2008 Jul;23(7):937-41. doi: 10.1007/s11606-008-0654-5.

The effect of physician continuity on diabetic outcomes in a resident continuity clinic.

Author information

  • 1Department of General Internal Medicine, Division of Internal Medicine, University of Kentucky College of Medicine, Lexington, KY, USA. angelatackett@uky.edu

Abstract

BACKGROUND:

Conflicting data exists regarding the effect of continuity on diabetes care. Resident physicians frequently treat patients with diabetes in their continuity clinics; however, maintaining continuity in a resident clinic can be very challenging.

OBJECTIVE:

To determine if resident continuity is associated with improvement in diabetic outcomes (HgA1c, LDL, blood pressure) in a resident clinic.

DESIGN AND SETTING:

Retrospective analysis of data obtained from a medical record review of diabetic patients seen in a resident physician clinic.

MEASUREMENTS:

We measured continuity, using the Usual Provider of Continuity Index (UPC) for residents and faculty preceptors. We measured changes in HgA1c, LDL, and blood pressure over a 3-year period. Using repeated measures analysis of variance (ANOVA), we assessed the relationship between UPC and change in these diabetic outcomes.

RESULTS:

The resident UPC was 0.43, and the faculty preceptor UPC was 0.76. The overall change in HgA1c was -0.3. There was a statistically significant relationship between improvement in HgA1c and resident UPC (p = 0.02), but not faculty preceptor UPC. There was no association between resident or faculty preceptor continuity and change in LDL or blood pressure.

CONCLUSION:

This study showed a link between resident continuity and improvement in glycemic control in diabetic patients. Resident physicians have a greater opportunity to develop a personal relationship with their patients. This interpersonal continuity may be of benefit in patients with illnesses that requires a significant amount of self-management behaviors. Medical training programs should focus efforts on improving continuity in resident primary care clinics.

PMID:
18612720
[PubMed - indexed for MEDLINE]
PMCID:
PMC2517915
Free PMC Article
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