Diabetes Care
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
QUICK SEARCH:   [advanced]


     

Diabetes Care Publish Ahead of Print published online ahead of print March 2, 2007
DOI: 10.2337/dc07-0029
This Article
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
dc07-0029v1
30/6/1442    most recent
Right arrow Purchase Article
Right arrow View Shopping Cart
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Request Permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Turchin, A.
Right arrow Articles by Pendergrass, M. L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Turchin, A.
Right arrow Articles by Pendergrass, M. L.
Social Bookmarking
Add to CiteULike   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?

Original Research

Relationship of Physician Volume to Process Measures and Outcomes in Diabetes

Alexander Turchin, MD, MS1,,2,,3, Maria Shubina, ScD4 and Merri L. Pendergrass, MD, PhD1,,3

1Division of Endocrinology, Brigham and Women's Hospital, Boston, MA
2Clinical Informatics Research and Development, Partners Healthcare System, Boston, MA
3Harvard Medical School, Boston, MA
4Center for Clinical Investigation, Brigham and Women's Hospital, Boston, MA

aturchin{at}partners.org

ABSTRACT

Objective:: The volume of patients cared for by an individual physician (physician volume) has been linked to improved outcomes for a number of conditions. It is not known whether a similar association exists for treatment of diabetes. In this study we aimed to determine whether physician volume is associated with improved process measures and outcomes in diabetes care.

Research Design and Methods:: This retrospective cohort study analyzed electronic medical records data for 7,120 patients with diabetes treated by 368 primary care physicians at practices affiliated with two large academic hospitals. The associations between physician volume of diabetic patients (diabetes volume) and annual A1C and LDL testing, and blood pressure, A1C and LDL levels were evaluated.

Results:: In multivariable analysis absolute diabetes volume was linked to decreased odds of A1C testing (4% less for each additional patient seen; p = 0.05) and relative diabetes volume (fraction of the total patients seen who had diabetes) was associated with decreased odds of both A1C (25% less for every 10% increase in the number of diabetic patients seen annually; p = 0.03) and LDL testing (20% less for every 10% increase in the number of diabetic patients; p < 0.001). Physician volume was not significantly associated with the odds of blood pressure, A1C or LDL control at the end of the study.

Conclusions:: Higher physician volume in care of diabetic patients is associated with decreased adherence to surveillance guidelines and no measurable difference in treatment outcomes.


Add to CiteULike CiteULike   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?




HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Diabetes Diabetes Care Clinical Diabetes Diabetes Spectrum
Copyright © 2007 by the American Diabetes Association.