Abstract
Multidisciplinary treatment and continuity of care throughout treatment are important for ensuring metabolic control and avoiding complications in diabetic patients. This study examines the relationship between continuity of care of the treating disciplines and clinical evolution of patients. Data from 1836 adult patients experiencing type 2 diabetes mellitus were analyzed, in a period between 12 and 24 months. Continuity was measured by using four well known indices: Usual Provider Continuity (UPC), Continuity of Care Index (COCI), Herfindahl Index (HI), and Sequential Continuity (SECON). Patients were divided into five segments according to metabolic control: well-controlled, worsened, moderately decompensated, highly decompensated, and improved. Well-controlled patients had higher continuity by physicians according to UPC and HI indices (p-values 0.029 and <0.003), whereas highly decompensated patients had less continuity in HI (p-value 0.020). Continuity for nurses was similar, with a greater continuity among well-controlled patients (p-values 0.015 and 0.001 for UPC and HI indices), and less among highly decompensated patients (p-values 0.004 and <0.001 for UPC and HI indices). Improved patients had greater adherence to the protocol than those who worsened. The SECON index showed no significant differences across the disciplines. This study identified a relationship between physicians and nurse’s continuity of care and metabolic control in patients with diabetes, consistent with qualitative findings that highlight the role of nurses in treatment.
Highlights
The rise in life expectancy in the past 50 years and the subsequent aging of the population has increased the prevalence of chronic diseases [1]
This study identified a relationship between physicians and nurse’s continuity of care and metabolic control in patients with diabetes, consistent with qualitative findings that highlight the role of nurses in treatment
Research can focus on concepts such as continuity of care (COC) and multidisciplinarity from a data analysis viewpoint, to enable decision-making that may impact a large segment of the affected population
Summary
The rise in life expectancy in the past 50 years and the subsequent aging of the population has increased the prevalence of chronic diseases [1]. Mellitus (T2DM) has almost doubled since 1980 [2]. Persons experiencing this disease frequently present comorbidities and complications [3]. The large amount of information that is available in electronic clinical records (ECR) have made it possible to apply data science with the aim of positively impacting society [5]. Research can focus on concepts such as continuity of care (COC) and multidisciplinarity from a data analysis viewpoint, to enable decision-making that may impact a large segment of the affected population
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