Primary Care Physicians Perform Well on Diabetes Care Measures

Higher rates of lifestyle advice, medication intensification than covering docs, midlevels

FRIDAY, Dec. 28 (HealthDay News) -- Compared to covering physicians or midlevel providers, primary care physicians (PCPs) perform better on multiple critical process measures for diabetes care, according to a study published online Dec. 10 in Diabetes Care.

Fritha Morrison, M.P.H., from Brigham and Women's Hospital in Boston, and colleagues retrospectively analyzed 584,587 encounters between 27,225 diabetes patients and their PCPs. Patients had elevated A1C, blood pressure, and/or low-density lipoprotein cholesterol and were monitored for at least two years.

The researchers found that 83 percent of the encounters were with primary care physicians (PCPs), 13 percent were with covering physicians, and 5 percent were with midlevel providers. Compared to covering physicians and midlevel providers, the odds of medication intensification for PCPs were significantly higher (49 and 26 percent higher, respectively). Among PCPs, the odds of lifestyle counseling were also significantly higher (91 and 21 percent higher, respectively). Covering physicians were even less likely, by an additional 52 percent, to intensify medications during visits with acute complaints, and midlevel providers were a further 41 percent less likely to provide lifestyle counseling. Compared with PCPs, the time to the next encounter following a visit without acute complaints had a hazard ratio of 1.11 for covering physicians and 1.19 for midlevel providers (P < 0.0001 for both).

"PCPs provide better care through higher rates of medication intensification and lifestyle counseling," the authors write.

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