Table 3.
Effect of PCP Turnover on Ambulatory Care Quality
| Quality Care Measure | % of Patients Achieving Success on Each Performance Measure | Adjusted Percentage Point Difference Associated With PCP Turnover (95% CI)a | P Value | |
|---|---|---|---|---|
| No PCP Turnover | PCP Turnover | |||
| Patients with diabetes | ||||
| Retinal eye examination (n = 63 962) | 90.2 | 90.1 | −0.18 (−1.09 to 0.73) | .69 |
| Testing HbA1c (n = 63 990) | 98.8 | 98.5 | −0.29 (−0.61 to −0.03) | .08 |
| HbA1c ≤9% of total hemoglobin (n = 63 990) | 84.3 | 84.9 | 0.71 (−0.23 to 1.64) | .14 |
| Testing LDL cholesterol level (n = 63 959) | 97.7 | 97.7 | 0.07 (−0.41 to 0.54) | .75 |
| Controlling LDL cholesterol level (<100 mg/dL) (n = 63 949) | 72.4 | 70.1 | −0.96 (−2.33 to 0.41) | .16 |
| Patients with coronary artery disease | ||||
| Testing LDL cholesterol level (n = 41 851) | 96.8 | 96.7 | −0.06 (−0.68 to 0.56) | .85 |
| Controlling LDL cholesterol level (<100 mg/dL) (n = 41 844) | 72.6 | 69.9 | −1.53 (−3.14 to −0.07) | .06 |
| Hypertension | ||||
| Controlling blood pressure (<140/90 mm Hg) (n = 138 548) | 80.4 | 78.7 | −1.44 (−2.24 to −0.65) | <.001 |
| Screening or prevention | ||||
| Breast cancer screening (n = 19 231) | 88.3 | 88.9 | 0.33 (−1.27 to 1.92) | .69 |
| Colon cancer screening (n = 149 478) | 83.5 | 83.6 | 0.34 (−0.39 to 1.08) | .36 |
| Influenza vaccine (n = 42 977) | 69.6 | 70.2 | 0.57 (−0.95 to 2.08) | .46 |
Abbreviations: HbA1c, hemoglobin A1c; LDL, low-density lipoprotein; PCP, primary care provider.
SI conversion factor: To convert LDL cholesterol to millimoles per liter, multiply by 0.0259.
a
Analysis was adjusted for age, sex, race/ethnicity, income, and baseline illness severity and included clinic-level fixed effects.