Effects of between visit physician-patient communication on Diabetes Recognition Program scores

摘要

Objective. To determine whether physicians who interact with their patients between office visits using secure messaging and! phone provide better care for patients with diabetes when controlling for physician, patient and care center characteristics.Design. Retrospective study.Setting. Kaiser Permanente Mid-Adantic States.Participants. 174 Primary Care Physicians.Intervention. We modeled the relationship between communication via secure messaging or phone communication Diabetes Recognition Program (DRP) scores with a Generalized Estimating Equations model. Covariates included physicianl age and panel size, patient age, race, income and number of comorbidities, and the population density around the care center. IMain Outcome Measure. DRP scores.Results. Physicians whose patients were predominandy white or mixed race were more likely than other physicians to use secure messaging and phone with their patients between visits, but there was no significant association between such contact! and DRP scores (P > 0.1). In contrast, physicians with predominandy black or Hispanic patients had significandy higher DRP scores associated with the use of secure messaging (P < 0.01) and higher, though not statistically significant, DEI scores associated with the use of phone (P< 0.1). These associations were strongest for outcome measures such as HbAlfl and lipid levels, and were weaker or nonexistent for process measures such as annual foot and eye exams.Conclusions. The use of secure messaging, and, to a lesser extent, phone, appears to be associated with higher quality dial betes care, particularly among at-risk populations.