HealthDay News — According to a study published in the Annals of Internal Medicine, primary care physician volume is associated with quality of diabetes care — with lower quality for higher overall volume and higher quality for higher diabetes-specific volume.

Andrew Cheung, MD, from the University of Toronto, and colleagues examined the correlation between primary care physician volume and quality of diabetes care in a cohort study involving 1,018,647 adults with diabetes who received care from 9014 primary care physicians in 2011. 

Over a 2-year period, the quality of care was measured using several indicators: disease monitoring (eye examination, hemoglobin A1c testing and low-density lipoprotein cholesterol testing), prescription of appropriate medications (angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers and statins) and adverse clinical outcomes (emergency department visits for hypoglycemia or hyperglycemia).

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The researchers found that there was a correlation between higher overall ambulatory volume and lower rates of appropriate diabetes monitoring and medication prescription. But better quality of care across all the indicators was seen for higher diabetes-specific volume.

“Primary care physicians with busier ambulatory patient practices delivered lower-quality diabetes care, but those with greater diabetes-specific experience delivered higher-quality care,” the authors write.


Cheung A, et al. “Primary Care Physician Volume And Quality Of Diabetes Care”. Annals of Internal Medicine. 2016. doi: 10.7326/M16-1056. [Epub ahead of print]

Peterson KA. “Balancing Primary Diabetes Care Quality And Services”. Annals of Internal Medicine. 2016. doi: 10.7326/M16-2768. [Epub ahead of print]

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