Continuity and quality of care in type 2 diabetes: a Residency Research Network of South Texas study.

Abstract

We investigated the relationship between continuity of care and the quality of care received by patients with type 2 diabetes mellitus. We used a cross-sectional patient survey and medical record review. Consecutive patients with an established diagnosis of type 2 diabetes mellitus presented to 1 of 6 clinics within the Residency Research Network of South Texas, a network of 6 family practice residencies affiliated with the University of Texas Health Science Center at San Antonio. Continuity was measured as the proportion of visits within the past year to the patient's usual primary care provider. A quality of care score was computed based on the American Diabetes Association's Provider Recognition Program criteria from data collected through medical record review and patient surveys. Each patient was awarded points based on the presence or absence of each criterion. The continuity score was associated significantly with the quality of care score in the anticipated direction (r =.15, P =.04). Patients who had seen their usual providers within the past year were significantly more likely to have had an eye examination, a foot examination, 2 blood pressure measurements, and a lipid analysis. Continuity of care is associated with the quality of care received by patients with type 2 diabetes mellitus. Continuity of care may influence provider and patient behaviors in ways that improve quality. Further research on how continuity contributes to improved quality is needed.