Article Figures & Data
Figures
- Figure 1.
Association of community health center (CHC) size and interdisciplinary care team expertise with patient assessment of chronic care, 2011 to 2012. Margin plots depict adjusted score for Patient Assessment of Chronic Illness Care (PACIC-11). Overall interdisciplinary primary care team expertise includes community health workers, diabetes educators, nutritionists, pharmacists, mental health providers, and other general staff. Small CHC sites have less than 250 adult patients with diabetes compared with large community health center sites with 250 or more adult patients with diabetes.
Tables
- Table 1.
Adult Diabetic Patient Characteristics for the Overall Sample and Compared between Small and Large Community Health Center (CHC) Sites, 2011-2012
VariablePercentage of Population, Mean (Standard Error) Overall Small CHC Site Large CHC Site P-Value Female 57.6% 54.1% 59.8% .048* Age (years old) .36 26 to 35 3.0% 2.1% 3.5% 36 to 45 10.1% 11.8% 9.1% 46 to 55 23.8% 22.9% 24.3% 56 to 65 35.5% 36.4% 34.9% 66 to 75 19.3% 19.4% 19.3% 76+ 8.3% 7.4% 8.8% Race/ethnicity/language < .01* Chinese-speaking Asian 40.3% 30.4% 46.3% English-speaking Asian 8.5% 9.3% 7.9% English-speaking Latino 12.5% 13.8% 11.6% Spanish-speaking Latino 29.4% 38.8% 23.6% English-speaking other 9.5% 7.6% 10.6% Insurance source .20 Medicaid 33.0% 36.9% 30.7% Medicare 5.4% 6.0% 5.0% Other 2.8% 2.8% 2.8% Private 27.9% 26.0% 29.0% Uninsured 31.0% 28.3% 32.5% Total comorbidities 2.9 (1.9) 3.0 (1.9) 2.9 (1.9) .56 How long usual clinic .18 < 3 years 32.5% 32.4% 32.5% 3 to 5 years 28.7% 31.4% 27.0% 5+ years 38.9% 36.2% 40.5% Observations 1277 484 793 This comparison of means analyses utilizes χ2 tests for categorical variables and t-test for continuous variables to compare patient characteristics in small versus large community health center sites.
↵*P-values represent the significance of differences in individual characteristics between small versus large sites.
- Table 2.
Descriptive Statistics for Care Team Expertise, Hemoglobin A1c Control, and Patients’ Experiences of Chronic Care (PACIC-11) in the Overall Sample and Compared between Small and Large Community Health Center (CHC) Sites, 2011 to 2012
VariablePercentage of Population, Mean (Standard Error) Overall Small CHC Site Large CHC Site P-Value Overall team expertise, count 0.88 (1.34) 0.88 (1.39) 0.87 (1.31) .94 Interdisciplinary expertise on the primary care team, % Community health worker 11.7% 12.2% 11.3% .65 Diabetes educator 21.0% 22.1% 20.3% .44 Nutritionist 30.9% 30.4% 31.1% .77 Pharmacist 19.8% 21.1% 19.0% .38 Mental health provider 5.2% 4.5% 5.7% .38 Other staff 24.3% 28.7% 21.6% .01* Hemoglobin A1c control (<8.0%) 75.0% 75.8% 74.6% .99 Patients’ experiences of chronic care (PACIC-11) 51.27 53.53 49.90 .02* Observations 1277 484 793 This comparison of means analyses utilizes χ2 tests for categorical variables and t-test for continuous variables to compare average values of main predictor variables for patients in small versus large community health center sites.
↵*P-values represent the significance of differences in individual characteristics between small versus large CHC sites.
- Table 3.
Predictors of Odds of Hemoglobin A1c (HbA1c) and Patients’ Experiences of Chronic Care (PACIC-11), 2011 to 2012
Model 1: Odds of HbA1c Control Model 2: PACIC-11 Score Overall team expertise 1.07 (0.11) 2.15* (1.02) Large CHC site 0.76 (0.21) 1.89 (2.12) Large CHC site # overall team expertise 0.92 (0.10) −2.58* (1.04) Interdisciplinary expertise on the primary care team: Community health worker 0.93 (0.26) 7.67† (2.68) Diabetes educator 0.69 (0.15) 6.05† (2.00) Nutritionist 1.05 (0.22) 5.21† (1.98) Pharmacist 0.84 (0.19) −0.17 (2.19) Mental health provider 0.98 (0.34) −0.42 (3.29) Other staff 1.11 (0.24) 4.96* (2.03) Total comorbidities 0.99 (0.04) −0.03 (0.39) Female 1.26 (0.20) −1.96 (1.45) Race/ethnicity/language Chinese-speaking Asian 0.99 (0.36) −5.37 (2.89) English-speaking Asian 0.58 (0.22) 10.73† (3.32) English-speaking Latino 0.49* (0.17) 7.85† (3.00) Spanish-speaking Latino 0.45* (0.14) 8.63† (2.74) English-speaking Other Ref. Ref. Insurance source Medicaid Ref. Ref. Medicare 1.44 (0.58) 0.48 (3.34) Other 0.70 (0.34) 3.62 (4.73) Private 1.21 (0.29) −1.87 (2.18) Uninsured 1.30 (0.31) −1.06 (2.07) Age (years old) 26 to 35 0.46 (0.19) −0.36 (4.20) 36 to 45 0.43† (0.11) 2.61 (2.54) 46 to 55 0.58† (0.11) −0.65 (1.84) 56 to 65 Ref. Ref. 66 to 75 1.03 (0.25) 1.47 (2.11) 76+ 1.29 (0.44) −0.08 (2.84) How long usual clinic (years) < 3 Ref. Ref. 3 to 5 1.22 (0.24) 2.63 (1.78) 5+ 1.09 (0.21) 2.45 (1.77) Constant 0.88 (0.36) 50.97‡ (3.13) Ψ 0.37 (0.14) 2.07 (2.19) Θ 24.00 (0.48) Observations 1125 1277 CHC, community health centers.
Standard errors in parentheses.
Model 1 displays odds ratio.
We were unable to assess 125 patients with no documentation of glycated hemoglobin (HbA1c) during the study period, leading to a Model 1 sub-sample of 1125.
↵*P < .05, †P < .01, ‡P < .001.
