Evidence map›Paper›PMID 37311623›Full record

ArticleBMJ open quality2023

Impact of primary care usual provider type and provider interdependence on outcomes for patients with diabetes: a cohort study.

Christine Everett, Jacob Christy, Heather Batchelder, Perri A Morgan, Sharron Docherty, Valerie A Smith, John B Anderson, Anthony Viera, George L Jackson

Open access · goldAbstract read
In one paragraph

Article in BMJ open quality, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
2.2field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Observational
  2. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Christine EverettMedicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA ceverett@mcw.edu.ORCID 0000-0001-7743-9167
Jacob ChristyFamily Medicine and Community Health, Duke University School of Medicine, Durham, North Carolina, USA.
Heather BatchelderFamily Medicine and Community Health, Duke University School of Medicine, Durham, North Carolina, USA.
Perri A MorganPopulation Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA.
Sharron DochertyDuke University School of Nursing, Durham, North Carolina, USA.
Valerie A SmithPopulation Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA.
John B AndersonFamily Medicine and Community Health, Duke University School of Medicine, Durham, North Carolina, USA.
Anthony VieraPopulation Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA.
George L JacksonPopulation Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA.
Duke University · US

Funding

Impact of Primary Care Clinician Interdependence and Coordination on Quality of Care Delivered to Complex Older Patients with DiabetesK01AG053378 · NIA · DUKE UNIVERSITY · PI EVERETT, CHRISTINE M · 2016 to 2020
$611k
NIA NIH HHS K01 AG053378
6 · The paper itself

Abstract

backgroundInterprofessional primary care (PC) teams are key to the provision of high-quality care. PC providers often 'share' patients (eg, a patient may see multiple providers in the same clinic), resulting in between-visit interdependence between providers. However, concern remains that PC provider interdependence will reduce quality of care, causing some organisations to hesitate in creating multiple provider teams. If PC provider teams are formalised, the PC usual provider of care (UPC) type (physician, nurse practitioner (NP) or physician assistant/associate (PA)) should be determined for patients with varying levels of medical complexity.

objectiveTo evaluate the impact of PC provider interdependence, UPC type and patient complexity on diabetes-specific outcomes for adult patients with diabetes.

designCohort study using electronic health record data from 26 PC practices in central North Carolina, USA.

participantsAdult patients with diabetes (N=10 498) who received PC in 2016 and 2017. OUTCOME: Testing for diabetes control, testing for lipid levels, mean glycated haemoglobin (HbA1c) values and mean low-density lipoprotein (LDL) values in 2017.

resultsReceipt of guideline recommended testing was high (72% for HbA1c and 66% for LDL testing), HbA1c values were 7.5% and LDL values were 88.5 mg/dL. When controlling for a range of patient and panel level variables, increases in PC provider interdependence were not significantly associated with diabetes-specific outcomes. Similarly, there were no significant differences in the diabetes outcomes for patients with NP/PA UPCs when compared with physicians. The number and type of a patient's chronic conditions did impact the receipt of testing, but not average values for HbA1c and LDL.

conclusionsA range of UPC types on PC multiple provider teams can deliver guideline-recommended diabetes care. However, the number and type of a patient's chronic conditions alone impacted the receipt of testing, but not average values for HbA1c and LDL.

Indexed as

Diabetes MellitusAdultAmbulatory Care FacilitiesCohort StudiesGlycated HemoglobinHumansPrimary Health CareGlycated HemoglobinDIABETES MELLITUSPRIMARY CARETeams

Identifiers

PMID37311623
PMCPMC10277144
OpenAlexW4380480566

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.