Spotlight on office visits for diabetes

New data on how often diabetes patients visit their physicians were provided by 2 recent analyses.

In an interrupted time series study published in the July/August Annals of Family Medicine, researchers from Group Health in Seattle analyzed more than 18,000 diabetic patients' use of office visits, secure emailing, and telephone encounters as their practice transitioned to be a patient-centered medical home (PCMH). Over the 3 studied periods (before, during, and after the transition), office visits for these patients declined by a total of 8% (from 0.93 visit per quarter to 0.90 to 0.86). During that time, use of secure emailing increased significantly, leading to an increase in overall patient-practice contacts from 3.46 per quarter to 3.95 during the transition to 4.44 after. The researchers also did patient-level regression analyses, where they found that patients' increasing use of email and phone contacts was associated with an increase in their office visits. The results suggest that chronically ill patients do not use alternate means of communication with their clinicians as a substitute for in-person visits and patients may instead take the opportunity to address previously unmet needs, the study authors speculated. Future research should look at whether emails and phone calls reduce emergency or inpatient services, they suggested.

Physician visits by diabetes patients across the U.S. were tallied in a recent National Center for Health Statistics Data Brief, published by the CDC on July 31. In 2010, patients with diabetes made 113.3 million visits to office-based physicians, according to the brief, which is based on the National Ambulatory Medical Care Survey. Patients with diabetes who were age 65 and over had the highest rate of visits at 1,380 visits per 1,000 persons. The vast majority of the visits (87%) involved patients who had other chronic conditions in addition to diabetes. At 85% of visits, medications were either prescribed or continued, and many of the visits involved polypharmacy. Five or more drugs were prescribed or continued at 60% of the visits by elderly patients. The researchers noted that such data are useful for observing progress toward the Healthy People 2020 goal of reducing the burden of diabetes as well as the effects of changing standards of care.