Effects of physician specialty on use of antidiabetes drugs, processs and outcomes of diabetes care in a medical center
Journal
Journal of the Formosan Medical Association
Journal Volume
105
Journal Issue
10
Pages
821-831
Date Issued
2006
Author(s)
Lai M.-S.
Abstract
Background/Purpose: Physician characteristics might determine the quality of diabetes care. This study evaluated the effects of physician specialty on the use of antidiabetes drugs, process and outcomes of diabetes care Methods: In 2002, 12,023 diabetes patients visited outpatient clinics more than four times at National Taiwan University Hospital. One-tenth of the patients were randomly sampled out A retrospective chart review was conducted for those who were regularly cared for by endocrinologists (EN), other specialists in internal medicine (IM) and family medicine (FM) physicians. The use of antidiabetes drugs was assessed. Effects of physician specialty on the process or outcome indicators were analyzed by logistic or linear regression, accordingly. Results: A total of 875 diabetes patients (477 men, 398 women) with a mean age of 62.3 ± 12.7 years were recruited. EN patients had the highest rate of being prescribed insulin, metformin or nonsulfonylurea insulin secretagogues, and the lowest rate of being given sulfonylureas. EN patients showed a significantly better adherence to glucose checkup, glycosylated hemoglobin A1C measures and urinalysis than IM patients. EN patients also showed better adherence to glucose checkup and urinalysis than FM patients. EN patients had the lowest mean fasting plasma glucose (FPG) and lowest mean postprandial plasma glucose (PPG). The difference in PPG between EN and IM patients and the difference in FPG between EN and FM patients were persistently significant following adjustment by patient and physician characteristics. Conclusion: The use of antidiabetes drugs differed among patients cared for by EN, internists or generalists. Physician specialty had significant effects on the process and outcomes of diabetes care. ?2006 Elsevier & Formosan Medical Association.
Subjects
Diabetes care; Medications; Physician specialty; Process and outcomes
SDGs
Other Subjects
2,4 thiazolidinedione derivative; antidiabetic agent; glucose; hemoglobin A1c; insulin; metformin; oral antidiabetic agent; sulfonylurea; sulfonylurea derivative; adult; aged; article; controlled study; diabetes mellitus; drug use; family medicine; female; glucose blood level; glucose tolerance test; health care; health care delivery; health care quality; hemoglobin determination; human; linear regression analysis; logistic regression analysis; major clinical study; male; medical record review; medical specialist; patient compliance; postprandial state; treatment outcome; urinalysis
Publisher
Scientific Communications International Ltd
Type
journal article