Primary Care Workload Directly Associated With Quality of Diabetes Care

HealthDay News — Primary care physician volume is associated with quality of diabetes care, with lower quality for higher overall volume and higher quality for higher diabetes-specific volume, according to a study published in the Annals of Internal Medicine.

Andrew Cheung, MD, from the University of Toronto, and colleagues examined the correlation between primary care physician volume and quality of diabetes care in a cohort study involving 1,018,647 adults with diabetes who received care from 9,014 primary care physicians in 2011. 

Over a two-year period, the quality of care was measured using several indicators: disease monitoring (eye examination, hemoglobin A1c testing, and low-density lipoprotein cholesterol testing), prescription of appropriate medications (angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers and statins), and adverse clinical outcomes (emergency department visits for hypoglycemia or hyperglycemia). 

The researchers found that there was a correlation between higher overall ambulatory volume and lower rates of appropriate diabetes monitoring and medication prescription. But better quality of care across all the indicators was seen for higher diabetes-specific volume.

“Primary care physicians with busier ambulatory patient practices delivered lower-quality diabetes care, but those with greater diabetes-specific experience delivered higher-quality care,” the authors write.

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Cheung A, Stukel TA, Alter DA, et al. Primary care physician volume and quality of diabetes care: A population-based cohort study. [Published online ahead of print December 13, 2016]  Ann Intern Med.  doi: 10.7326/M16-1056.