Kimberley Kurek1, Bridget E Teevan2, Ianita Zlateva2, Daren R Anderson2. 1. Squirrel Hill Health Center, 4516 Browns Hill Road, Pittsburgh, PA, USA. kimberleykurek@gmail.com. 2. Weitzman Institute, Community Health Center, Inc., 631 Main Street, Middletown, CT, USA.
Abstract
OBJECTIVE: This study was conducted to better understand the relationship between patient-provider social concordance and cardiovascular risk factor control in patients with type 2 diabetes. METHODS: A retrospective study was conducted on adult patients with type 2 diabetes receiving care at Community Health Center, Inc. between July 1, 2012, and June 30, 2013. We utilized a composite score comprised of four social dimensions-age, gender, language, and race/ethnicity-to determine patient-provider social concordance (SC) and used binary logistic regression to relate SC and other potentially influential covariates with cardiovascular outcomes of interest (HgA1c, LDL, BP control). RESULTS: Patients were more likely to have uncontrolled BP if they were in low or medium SC dyads with their providers (OR = 0.689, 95 % CI = 0.480, 0.989; OR = 0.673, 95 % CI 0.486, 0.931), and they were more likely to have controlled BP and LDL in the setting of care continuity with a regular provider (OR = 1.069, 95 % CI 1.005, 1.136; OR = 1.113, 95 % CI 1.048, 1.182). CONCLUSIONS: Certain health outcomes may be susceptible to patient-provider social concordance or discordance. Continuity of care may serve a protective role in offsetting effects of patient-provider social mismatching.
OBJECTIVE: This study was conducted to better understand the relationship between patient-provider social concordance and cardiovascular risk factor control in patients with type 2 diabetes. METHODS: A retrospective study was conducted on adult patients with type 2 diabetes receiving care at Community Health Center, Inc. between July 1, 2012, and June 30, 2013. We utilized a composite score comprised of four social dimensions-age, gender, language, and race/ethnicity-to determine patient-provider social concordance (SC) and used binary logistic regression to relate SC and other potentially influential covariates with cardiovascular outcomes of interest (HgA1c, LDL, BP control). RESULTS:Patients were more likely to have uncontrolled BP if they were in low or medium SC dyads with their providers (OR = 0.689, 95 % CI = 0.480, 0.989; OR = 0.673, 95 % CI 0.486, 0.931), and they were more likely to have controlled BP and LDL in the setting of care continuity with a regular provider (OR = 1.069, 95 % CI 1.005, 1.136; OR = 1.113, 95 % CI 1.048, 1.182). CONCLUSIONS: Certain health outcomes may be susceptible to patient-provider social concordance or discordance. Continuity of care may serve a protective role in offsetting effects of patient-provider social mismatching.
Entities:
Keywords:
Cardiovascular risk factor control; Patient-provider relationship; Social concordance; Type 2 diabetes
Authors: Sherita Hill Golden; Arleen Brown; Jane A Cauley; Marshall H Chin; Tiffany L Gary-Webb; Catherine Kim; Julie Ann Sosa; Anne E Sumner; Blair Anton Journal: J Clin Endocrinol Metab Date: 2012-06-22 Impact factor: 5.958
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