Outcomes of patients with prevalent diabetes, stratified by whether or not the patient was cared for in a primary care network, based on the sample matched by propensity scores
| Outcome | Patients with physicians who never enrolled in a PCN n = 77 464 | Patients with physicians who enrolled in PCNs of interest n = 77 464 | Comparison of patients with prevalent diabetes cared for in PCNs with patients cared for outside PCNs (reference group) | |||
|---|---|---|---|---|---|---|
| Crude | Adjusted* | Crude | Adjusted* | Adjusted* measure (95% CI) | p value | |
| Rate of admissions to hospital or visits to emergency departments per 1000 patient months (95%CI) | 3.67 (3.49 to 3.86) | 1.96 (1.85 to 2.09) | 2.99 (2.83 to 3.17) | 1.58 (1.49 to 1.68) | IRR 0.81 (0.75 to 0.87) | < 0.001 |
| Rate of admissions to hospital per 1000 patient months (95% CI) | 0.69 (0.62 to 0.77) | 0.30 (0.26 to 0.35) | 0.52 (0.46 to 0.58) | 0.23 (0.20 to 0.26 | IRR 0.75 (0.64 to 0.87) | < 0.001 |
| Rate of visits to emergency departments per 1000 patient months (95% CI) | 2.97 (2.82 to 3.13) | 1.62 (1.52 to 1.73) | 2.47 (2.33 to 2.62) | 1.33 (1.25 to 1.42) | IRR 0.82 (0.76 to 0.88) | < 0.001 |
| Glycated hemoglobin, mean (95% CI) | n = 51 565 7.31 (7.30 to 7.33) | n = 51 565 7.26 (7.25 to 7.28) | n = 54 228 7.24 (7.23 to 7.26) | n = 54 228 7.20 (7.18 to 7.21) | MD −0.067 (−0.081 to −0.052) | < 0.001 |
| Mean glycated hemoglobin < 7.0, % (95% CI) | n = 51 565 51.8 (51.4 to 52.2) | n = 51 565 54.9 (54.4 to 55.5) | n = 54 228 53.2 (52.8 to 53.6) | n = 54 228 57.0 (56.4 to 57.6) | RR 1.02 (1.01 to 1.03) | < 0.001 |
| No. of measurements of glycated hemoglobin, mean (95% CI) | n = 51 565 1.99 (1.98 to 2.00) | n = 51 565 1.87 (1.86 to 1.88) | n = 54 228 2.15 (2.14 to 2.16) | n = 54 228 2.02 (2.01 to 2.03) | MD 0.078 (0.070 to 0.085) | < 0.001 |
| Patients who saw an ophthalmologist/optometrist, % (95% CI) | 27.5 (27.2 to 27.9) | 25.7 (25.4 to 26.0) | 32.7 (32.4 to 33.0) | 31.1 (30.8 to 31.5) | RR 1.19 (1.17 to 1.21) | < 0.001 |
| Patients who had albumin–creatinine ratio measured, % (95% CI) | 41.0 (40.6 to 41.3) | 36.7 (36.3 to 37.1) | 44.7 (44.4 to 45.1) | 41.2 (40.8 to 41.6) | RR 1.10 (1.09 to 1.11) | < 0.001 |
| Patients who had LDL measured, % (95% CI) | 61.8 (61.4 to 62.1) | 61.5 (61.2 to 61.9) | 63.5 (63.1 to 63.8) | 63.8 (63.4 to 64.1) | RR 1.03 (1.02 to 1.04) | < 0.001 |
| Patients who had glycated hemoglobin measured, % (95% CI) | 66.6 (66.2 to 66.9) | 67.3 (66.9 to 67.6) | 70.0 (69.7 to 70.3) | 72.1 (71.7 to 72.5) | RR 1.05 (1.04 to 1.06) | < 0.001 |
| Patients taking a statin,† % (95% CI) | n = 31 776 54.1 (53.6 to 54.7) | n = 31 776 53.7 (53.2 to 54.3) | n = 32 209 55.5 (55.0 to 56.1) | n = 32 209 55.8 (55.2 to 56.4) | RR 1.03 (1.02 to 1.05) | < 0.001 |
| Patients with proteinuria taking an ACE/ARB,† % (95% CI) | n = 6 979 77.6 (76.7 to 78.6) | n = 6 979 80.3 (79.3 to 81.2) | n = 6 273 79.3 (78.2 to 80.3) | n = 6 27382.3 (81.3 to 83.3) | RR 1.02 (1.01 to 1.04) | 0.007 |
| Patients taking metformin† who received any oral hypoglycemic drug during the assessment period but were not receiving insulin, % (95% CI) | n = 4 206 85.3 (84.2 to 86.4) | n = 4 206 87.2 (86.1 to 88.2) | n = 3 575 84.3 (83.1 to 85.5) | n = 3 575 86.4 (85.2 to 87.5) | RR 0.99 (0.97 to 1.01) | 0.24 |
| Rate of outpatient visits to primary care physicians per 1000 patient-months (95%CI) | 627.7 (623.5 to 631.9) | 596.5 (592.8 to 600.3) | 631.1 (626.8 to 635.5) | 591.8 (588.2 to 595.4) | IRR 0.99 (0.98 to 1.00) | 0.07 |
| Rate of outpatient visits to specialists in internal medicine/endocrinology per 1000 patient-months (95%CI) | 51.8 (50.9 to 52.7) | 44.6 (43.8 to 45.3) | 52.7 (51.7 to 53.7) | 45.1 (44.3 to 45.9) | IRR 1.01 (0.99 to 1.04) | 0.34 |
Note: ACE = angiotensin-converting enzyme, ARB = angiotensin receptor blocker, CI = confidence interval, IRR = incidence rate ratio, LDL = low-density lipoprotein, MD = mean difference, PCN = primary care network, RR = risk ratio.
↵* Adjusted for the demographic factors including age, sex, socioeconomic status, and score on the Charlson comorbidity index.
↵† Among patients aged ≥ 66 yrs.