Does having a personal physician improve quality of care in diabetes?

J Am Board Fam Med. 2010 Jan-Feb;23(1):82-7. doi: 10.3122/jabfm.2010.01.090102.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Blood Pressure
  • Cholesterol, LDL / blood
  • Continuity of Patient Care
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / therapy*
  • Family Practice / statistics & numerical data*
  • Female
  • Glycated Hemoglobin / metabolism
  • Group Practice / statistics & numerical data
  • Health Services Accessibility / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Patient Compliance / statistics & numerical data
  • Personal Health Services / supply & distribution*
  • Physician-Patient Relations
  • Population Surveillance
  • Quality Assurance, Health Care / statistics & numerical data*
  • Registries
  • Retrospective Studies
  • South Carolina

Substances

  • Cholesterol, LDL
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human