Research ArticleFamily Medicine and the Health Care System

Visit Entropy Associated with Diabetic Control Outcomes

Benjamin T. Dilger, Margaret C. Gill, Jill G. Lenhart and Gregory M. Garrison
The Journal of the American Board of Family Medicine September 2019, 32 (5) 739-745; DOI: https://doi.org/10.3122/jabfm.2019.05.190026

Article Figures & Data

Figures

  • Figure 1.
    Figure 1.

    Factors associated with diabetic D5 control. NOTE: The other continuity measures (usual provider of care (UPC), Bice-Boxerman continuity of care index (COC), and sequential continuity of care index (SECON)) showed nonsignificant odds ratios that crossed 1.0 when run in separate models. CI, confidence interval; ESL, English as a Second Language.

  • Figure 2.
    Figure 2.

    Distribution of continuity measures. UPC, usual provider of care; COC, Bice-Boxerman continuity of care index; SECON, sequential continuity of care index.

Tables

  • Table 1.
  • Table 2.

    Bivariate Comparison Between Controlled and Uncontrolled D5 Patients

    UncontrolledControlledP Value
    N (%)3378 (51.3)3210 (48.7)NA
    Age, years mean (SD)58.4 (12.6)61.7 (11.8)<.001
    Sex, Female (%)1521 (45.0)1409 (43.9).359
    Race, Non-white (%)468 (13.9)419 (13.1).348
    Language, Non-English (%)235 (7.0)190 (5.9).088
    Education<.001
        Unknown712 (21.1%)524 (16.3%)
        Some high school77 (2.3%)75 (2.3%)
        High school or GED792 (23.4%)734 (22.9%)
        Some college or 2-year degree1042 (30.8%)901 (28.1%)
        College Graduate430 (12.7%)497 (15.5%)
        Post-Graduate Studies325 (9.6%)479 (14.9%)
    Charlson comorbidity, mean (SD)1.5 (1.2)1.5 (1.2).266
    Initial Hemoglobin a1c, mean (SD)8.0 (1.8)7.2 (1.4)<.001
    Endocrine consult (%)805 (23.8)661 (20.6).002
    Total no. visits, mean (SD)21.4 (21.8)21.5 (21.6).168
    Continuity measures
        Entropy, mean, median, (SD)3.59, 3.59 (0.69)3.55, 3.56 (0.69).034
        UPC, mean (SD)0.34, 0.29 (0.20)0.34, 0.29 (0.19).333
        COC, mean (SD)0.14, 0.08 (0.18)0.15, 0.09 (0.18).008
        SECON, mean (SD)0.19, 0.13 (0.21)0.18, 0.13 (0.20).848

    • NA, Not applicable; SD, standard deviation; GED, graduate equivalency degree.

  • Table 3.

    Example Visit Patterns Contrasting COC and VE

    PatternDescriptionCOCVE
    AVisiting the primary physician 5 times, the care team advanced practitioner 3 times, and an endocrinologist twice.0.242.37
    BVisiting the primary physician twice, and seeing 4 other clinicians a total of once each for acute visits.0.073.42
    CVisiting only the primary physician 4 times.1.002.04
    DVisiting only the primary physician twice.1.003.11

    • COC, Bice-Boxerman continuity of care index; VE, visit entropy.

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