Effects of Practice Ownership and Integration of Health Services on Adherence to Diabetes Guidelines

Autor: Nick Kostrubsky, Jeffrey S. Harman
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Journal of Primary Care & Community Health, Vol 15 (2024)
Druh dokumentu: article
ISSN: 2150-1327
21501319
DOI: 10.1177/21501319241259685
Popis: Objective: There has been a trend toward hospital systems and insurers acquiring privately owned physician practices and subsequently converting them into vertically integrated practices. The purpose of this study is to observe whether this change in ownership of a medical practice influences adherence to clinical guidelines for the management of type 1 and type 2 diabetes. Methods: This is an observational study using pooled cross-sectional data (2014-2016 and 2018-2019) from the National Ambulatory Medical Care Survey, a nationally representative probability sample of US office-based physician visits. A total of 7499 chronic routine follow ups and preventative care visits to non-integrated (solo and group physician practices) and integrated practices were analyzed to see whether guideline concordant care was provided. Measures included 7 services that are recommended annually for individuals with type 1 and type 2 diabetes (HbA1c, lipid panel, serum creatinine, depression screening, influenza immunization, foot examination, and BMI). Results: Compared to non-integrated physician practices, vertically integrated practices had higher rates of hemoglobin A1C testing (odds ratio 1.58 [95% CI 1.07-2.33], P
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