medwireNews: Increased team-based continuity of care correlates with decreased risk for cardiovascular disease (CVD) in people with type 2 diabetes, researchers report in Diabetes Care.
“This suggests a potential flexible alternative implementation of continuity of care in public clinics,” write Eric Yuk Fai Wan (University of Hong Kong, China) and colleagues, noting that “[m]aintaining a one-to-one patient–physician relationship is challenging” in such settings.
Using the usual provider continuity index to measure team-based continuity of care, they divided 312,068 individuals (52.9% women, mean age 63.4 years) with type 2 diabetes attending a public-sector clinic into quartiles based on their score (<0.50, 0.50–0.74, 0.75–0.91, and 0.92–1.0).
There were a total of 52,428 CVD events during an average follow-up of 6.5 years. The CVD incidence rate decreased as continuity of care increased, from 26.1 cases per 1000 person–years in the lowest quartile to 25.4, 24.6, and 23.6 cases per 1000 person–years in the second, third, and fourth quartiles, respectively. Compared with people in the first quartile, those in the second, third, and fourth had a significantly lower risk for CVD with corresponding hazard ratios of 0.95, 0.92, and 0.87.
A similar trend was observed when looking at the subtypes of CVD, including coronary heart disease and stroke. In addition, the association was stronger in people younger than 65 years of age relative to older individuals.
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