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- Title
The effect of physician continuity on diabetic outcomes in a resident continuity clinic.
- Authors
Dearinger, Angela T.; Wilson, John F.; Griffith, Charles H.; Scutchfield, F. Douglas
- Abstract
<bold>Background: </bold>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.<bold>Objective: </bold>To determine if resident continuity is associated with improvement in diabetic outcomes (HgA1c, LDL, blood pressure) in a resident clinic.<bold>Design and Setting: </bold>Retrospective analysis of data obtained from a medical record review of diabetic patients seen in a resident physician clinic.<bold>Measurements: </bold>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.<bold>Results: </bold>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.<bold>Conclusion: </bold>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.
- Subjects
ANALYSIS of variance; PEOPLE with diabetes; MEDICAL care; MEDICAL informatics; PHYSICIANS; TREATMENT of diabetes; MEDICAL quality control; RESEARCH; INTERNAL medicine; RESEARCH methodology; CURRICULUM; MEDICAL cooperation; EVALUATION research; CONTINUUM of care; INTERNSHIP programs; COMPARATIVE studies; OUTPATIENT services in hospitals
- Publication
JGIM: Journal of General Internal Medicine, 2008, Vol 23, Issue 7, p937
- ISSN
0884-8734
- Publication type
journal article
- DOI
10.1007/s11606-008-0654-5