Evidence map›Paper›PMID 39197879›Full record

ArticleBJGP open2025

Continuity of care and mortality in patients with type 2 diabetes: a cohort study.

Eero H Mellanen, Timo Kauppila, Hannu Kautiainen, Mika T Lehto, Ossi Rahkonen, Kaisu H Pitkälä, Merja K Laine

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In one paragraph

Article in BJGP open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

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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

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

7 authors.

Eero H MellanenDepartment of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland eero.mellanen@helsinki.fi.ORCID https://orcid.org/0000-0003-4946-5768
Timo KauppilaDepartment of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.ORCID https://orcid.org/0000-0002-6155-0300
Hannu KautiainenDepartment of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.ORCID https://orcid.org/0000-0003-0786-0858
Mika T LehtoDepartment of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.ORCID https://orcid.org/0000-0001-7315-2118
Ossi RahkonenDepartment of Public Health, University of Helsinki, Helsinki, Finland.ORCID https://orcid.org/0000-0002-7202-3274
Kaisu H PitkäläDepartment of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.ORCID https://orcid.org/0000-0001-9659-6985
Merja K LaineDepartment of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.ORCID https://orcid.org/0000-0002-1848-1514

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHow GP continuity of care (GP-CoC) affects mortality in patients with type 2 diabetes (T2D) is unclear.

aimTo examine the effect of having no continuity of care (CoC) and GP-CoC on mortality in primary health care (PHC) patients with T2D. DESIGN &

settingA cohort study in patients aged ≥60 years with T2D, which was conducted within the public PHC of the city of Vantaa, Finland.

methodThe inclusion period was between 2002 and 2011 and follow-up period between 2011 and 2018. Six groups were formed (no appointments, one appointment and Modified, Modified Continuity Index [MMCI] quartiles). Mortality was measured with standardised mortality ratio (SMR) and adjusted hazard ratio (aHR). GP-CoC was measured with MMCI. Comorbidity status was determined with Charlson Comorbidity Index (CCI).

resultsIn total, 11 020 patients were included. Mean follow-up time was 7.3 years. SMRs for the six groups (no appointments, one appointment, MMCI quartiles) were 2.46 (95% confidence interval [CI] = 2.24 to 2.71), 3.55 (95% CI = 3.05 to 4.14), 1.15 (95% CI = 1.06 to 1.25), 0.97 (95% CI = 0.89 to 1.06), 0.92 (95% CI = 0.84 to 1.01) and 1.21 (95% CI = 1.11 to 1.31), respectively. With continuous MMCI, mortality formed a U-curve. The inflection point was at a MMCI value of 0.65 with corresponding SMR of 0.86. Age and CCI aHR for death between men and women was 1.45 (95% CI = 1.35 to 1.58).

conclusionPatients with no CoC had the highest mortality. In patients having care over time, the effect of GP-CoC on mortality was minor and mortality increased with high GP-CoC.

Indexed as

continuity of patient carediabetes mellitusfamily medicineprimary healthcare

Identifiers

PMID39197879
PMCPMC12138002

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