PT  - JOURNAL ARTICLE
AU  - Braden J. Manns
AU  - Marcello Tonelli
AU  - Jianguo Zhang
AU  - David J.T. Campbell
AU  - Peter Sargious
AU  - Bharati Ayyalasomayajula
AU  - Fiona Clement
AU  - Jeffrey A. Johnson
AU  - Andreas Laupacis
AU  - Richard Lewanczuk
AU  - Kerry McBrien
AU  - Brenda R. Hemmelgarn
TI  - Enrolment in primary care networks: impact on outcomes and processes of care for patients with diabetes
AID  - 10.1503/cmaj.110755
DP  - 2012 Feb 07
TA  - Canadian Medical Association Journal
PG  - E144--E152
VI  - 184
IP  - 2
4099  - http://www.cmaj.ca/content/184/2/E144.short
4100  - http://www.cmaj.ca/content/184/2/E144.full
SO  - CMAJ2012 Feb 07; 184
AB  - Background: Primary care networks are a newer model of primary care that focuses on improved access to care and the use of multidisciplinary teams for patients with chronic disease. We sought to determine the association between enrolment in primary care networks and the care and outcomes of patients with diabetes.Methods: We used administrative health care data to study the care and outcomes of patients with incident and prevalent diabetes separately. For patients with prevalent diabetes, we compared those whose care was managed by physicians who were or were not in a primary care network using propensity score matching. For patients with incident diabetes, we studied a cohort before and after primary care networks were established. Each cohort was further divided based on whether or not patients were cared for by physicians enrolled in a network. Our primary outcome was admissions to hospital or visits to emergency departments for ambulatory care sensitive conditions specific to diabetes.Results: Compared with patients whose prevalent diabetes is managed outside of primary care networks, patients in primary care networks had a lower rate of diabetes-specific ambulatory care sensitive conditions (adjusted incidence rate ratio 0.81, 95% confidence interval [CI] 0.75 to 0.87), were more likely to see an ophthalmologist or optometrist (risk ratio 1.19, 95% CI 1.17 to 1.21) and had better glycemic control (adjusted mean difference −0.067, 95% CI −0.081 to −0.052).Interpretation: Patients whose diabetes was managed in primary care networks received better care and had better clinical outcomes than patients whose condition was not managed in a network, although the differences were very small.