Article Figures & Data
Figures
- Figure 1.
Time to next appointment and indicated services delivered.
Tables
Characteristics Number Age, y, mean (SD) 59.1 (13.0) Male, % 51.3 Hispanic, % 57.1 Did not graduate from high school, % 34.3 No. of chronic diagnoses, mean (SD) 4.8 (2.3) No. of chronic medications, mean (SD) 6.4 (3.1) Content Number Family member or significant other present, % 34.1 Length of visit, min, mean (SD) 17.5 (8.8) No. of topics, questions, or symptoms, mean (SD) 17.6 ( 7.6) No. of prescriptions provided, mean (SD) 2.0 (1.8) Change in medication, % 26.8 Diet discussed, % 70.1 Diabetes education referral, % 13.7 Referral to other health care clinician, % 31.8 Chronic Encounters (n = 161) Acute Encounters (n = 50) Diabetes Service Indicated No. Delivered No. (%) Indicated No. Delivered No. (%) HbA1c = gyclosylated hemoglobin. *If no previous diagnosis of nephropathy. HbA1c 127 118 (92.9) 36 26 (72.2) Lipid panel 127 96 (75.6) 36 26 (72.2) Urine microalbumin* 125 73 (58.4) 38 19 (50.5) Referral for dilated eye examination 82 37 (45.1) 31 6 (19.3) Foot examination or podiatry referral 144 98 (68.1) 46 15 (32.6)
The Article in Brief
Encounters by patients with Type 2 diabetes are complex and demanding: an observational study
Michael L. Parchman, MD, MPH , and colleagues
Background During most patient visits, doctors have �competing demands,� that is, multiple health conditions and preventive measures that demand their attention. Because of limited time, doctors often prioritize those demands and deal only with the most urgent problems. This study looks at whether competing demands in the primary care doctor visit affect the delivery of medical care for diabetes.
What This Study Found Needed diabetes services are less likely to occur during visits for the competing demand of acute illness. When fewer diabetes services are delivered, follow-up visits are scheduled sooner. More diabetes care is given when visits are longer.
Implications
- Competing demands during visits with patients who have type 2 diabetes can interfere with delivering needed diabetes services. In spite of this, primary care practices often make use of the acute illn
- Changes in the primary care practice setting could improve the quality of diabetes care. New models of care are needed, such as group visits, as well as information technology that allows for manageme
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