title: Diabetes Quality of Care Before and After Implementation of a Resident Clinic Practice Partnership System.
abstract: Deficiencies in resident diabetes care quality may relate to continuity clinic design. This retrospective analysis compared diabetes care processes and outcomes within a traditional resident continuity clinic structure (2005) and after the implementation of a practice partnership system (PPS; 2009). Under PPS, patients were more likely to receive annual foot examinations (odds ratio [OR] = 11.6; 95% confidence interval [CI] = 7.2, 18.5), microalbumin screening (OR = 2.4; 95% CI = 1.6, 3.4), and aspirin use counseling (OR = 3.8; 95% CI = 2.5, 6.0) and were less likely to receive eye examinations (OR = 0.54; 95% CI = 0.36, 0.82). Hemoglobin A1c and lipid testing were similar between periods, and there was no difference in achievement of diabetes and blood pressure goals. Patients were less likely to achieve cholesterol goals under PPS (OR = 0.62; 95% CI = 0.39, 0.98). Resident practice partnerships may improve processes of diabetes care but may not affect intermediate outcomes.
authors.affiliation: 1 Duke University, Durham, NC.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Campbell
authors.affiliation: 1 Duke University, Durham, NC.|2 Durham VAMC, NC.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Crowley
authors.affiliation: 3 St Luke's Health System, Boise, ID.
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Powers
authors.affiliation: 2 Durham VAMC, NC.
authors.forename: Linda L
authors.initials: LL
authors.lastname: Sanders
authors.affiliation: 1 Duke University, Durham, NC.|2 Durham VAMC, NC.
authors.forename: Maren K
authors.initials: MK
authors.lastname: Olsen
authors.affiliation: 2 Durham VAMC, NC.
authors.forename: Susanne
authors.initials: S
authors.lastname: Danus
authors.affiliation: 1 Duke University, Durham, NC.
authors.forename: Diana B
authors.initials: DB
authors.lastname: McNeill
authors.affiliation: 1 Duke University, Durham, NC.
authors.forename: Aimee K
authors.initials: AK
authors.lastname: Zaas
mesh_terms: D000368:Aged; D000553:Ambulatory Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D001794:Blood Pressure; D003920:Diabetes Mellitus / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency / Q000458:organization & administration* / Q000706:statistics & numerical data; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D012189:Retrospective Studies
chemical_list: D006442:Glycated Hemoglobin; D008055:Lipids
keywords: diabetes care; graduate medical education; internal medicine residency training; quality of care; residency continuity clinics