| Title |
Interpersonal continuity of primary care of veterans with diabetes: a cohort study using electronic health record data
|
|---|---|
| Published in |
BMC Primary Care, July 2018
|
| DOI | 10.1186/s12875-018-0823-5 |
| Pubmed ID | |
| Authors |
Christine M. Everett, Perri Morgan, Valerie A. Smith, Sandra Woolson, David Edelman, Cristina C. Hendrix, Theodore Berkowitz, Brandolyn White, George L. Jackson |
| Abstract |
Continuity of care is a cornerstone of primary care and is important for patients with chronic diseases such as diabetes. The study objective was to examine patient, provider and contextual factors associated with interpersonal continuity of care (ICoC) among Veteran's Health Administration (VHA) primary care patients with diabetes. This patient-level cohort study (N = 656,368) used electronic health record data of adult, pharmaceutically treated patients (96.5% male) with diabetes at national VHA primary care clinics in 2012 and 2013. Each patient was assigned a "home" VHA facility as the primary care clinic most frequently visited, and a primary care provider (PCP) within that home clinic who was most often seen. Patient demographic, medical and social complexity variables, provider type, and clinic contextual variables were utilized. We examined the association of ICoC, measured as maintaining the same PCP across both years, with all variables simultaneously using logistic regression fit with generalized estimating equations. Among VHA patients with diabetes, 22.3% switched providers between 2012 and 2013. Twelve patient, two provider and two contextual factors were associated with ICoC. Patient characteristics associated with disruptions in ICoC included demographic factors, medical complexity, and social challenges (example: homeless at any time during the year OR = 0.79, CI = 0.75-0.83). However, disruption in ICoC was most likely experienced by patients whose providers left the clinic (OR = 0.09, CI = 0.07-0.11). One contextual factor impacting ICoC included NP regulation (most restrictive NP regulation (OR = 0.79 CI = 0.69-0.97; reference least restrictive regulation). ICoC is an important mechanism for the delivery of quality primary care to patients with diabetes. By identifying patient, provider, and contextual factors that impact ICoC, this project can inform the development of interventions to improve continuity of chronic illness care. |
X Demographics
The data shown below were collected from the profiles of 4 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Portugal | 1 | 25% |
| United States | 1 | 25% |
| France | 1 | 25% |
| Unknown | 1 | 25% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Practitioners (doctors, other healthcare professionals) | 2 | 50% |
| Members of the public | 2 | 50% |
Mendeley readers
The data shown below were compiled from readership statistics for 64 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 64 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 7 | 11% |
| Researcher | 6 | 9% |
| Student > Ph. D. Student | 5 | 8% |
| Student > Doctoral Student | 4 | 6% |
| Student > Bachelor | 3 | 5% |
| Other | 11 | 17% |
| Unknown | 28 | 44% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 9 | 14% |
| Nursing and Health Professions | 7 | 11% |
| Social Sciences | 5 | 8% |
| Business, Management and Accounting | 3 | 5% |
| Psychology | 3 | 5% |
| Other | 4 | 6% |
| Unknown | 33 | 52% |
Attention Score in Context
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 28 September 2018.
All research outputs
#15,175,718
of 25,385,509 outputs
Outputs from BMC Primary Care
#1,381
of 2,359 outputs
Outputs of similar age
#180,085
of 340,947 outputs
Outputs of similar age from BMC Primary Care
#35
of 69 outputs
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We're also able to compare this research output to 69 others from the same source and published within six weeks on either side of this one. This one is in the 47th percentile – i.e., 47% of its contemporaries scored the same or lower than it.