Patient-Provider Social Concordance and Health Outcomes in Patients with Type 2 Diabetes: a Retrospective Study from a Large Federally Qualified Health Center in Connecticut.

Abstract

This study was conducted to better understand the relationship between patient-provider social concordance and cardiovascular risk factor control in patients with type 2 diabetes. A retrospective study was conducted on adult patients with type 2 diabetes receiving care at Community Health Center, Inc. between July 1, 2012, and June 30, 2013. We utilized a composite score comprised of four social dimensions-age, gender, language, and race/ethnicity-to determine patient-provider social concordance (SC) and used binary logistic regression to relate SC and other potentially influential covariates with cardiovascular outcomes of interest (HgA1c, LDL, BP control). Patients were more likely to have uncontrolled BP if they were in low or medium SC dyads with their providers (OR = 0.689, 95% CI = 0.480, 0.989; OR = 0.673, 95% CI 0.486, 0.931), and they were more likely to have controlled BP and LDL in the setting of care continuity with a regular provider (OR = 1.069, 95% CI 1.005, 1.136; OR = 1.113, 95% CI 1.048, 1.182). Certain health outcomes may be susceptible to patient-provider social concordance or discordance. Continuity of care may serve a protective role in offsetting effects of patient-provider social mismatching.