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

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.

journal_name

J Gen Intern Med

journal_title

Journal of general internal medicine

authors

Dearinger AT,Wilson JF,Griffith CH,Scutchfield FD

doi

10.1007/s11606-008-0654-5

subject

Has Abstract

pub_date

2008-07-01 00:00:00

pages

937-41

issue

7

eissn

0884-8734

issn

1525-1497

journal_volume

23

pub_type

杂志文章

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