Characteristics of patients with diabetes with a specialist physician visit for diabetes, by physician payment model
| Characteristic | Total n = 23 954 | Fee for service n = 21 218 | Salary based n = 2736 | Standardized difference |
|---|---|---|---|---|
| Age, yr, mean ± SD | 56.3 ± 15.4 | 56.9 ± 14.8 | 52.3 ± 18.5 | 27.2 |
| 18–29 yr, no. (%) | 1495 (6.2) | 1076 (5.1) | 419 (15.3) | |
| > 29 yr, no. (%) | 22 459 (93.8) | 20 142 (94.9) | 2317 (84.7) | |
| Female, no. (%) | 10 878 (45.4) | 9430 (44.4) | 1448 (52.9) | 17.0 |
| First Nations status, no. (%) | 886 (3.7) | 691 (3.3) | 195 (7.1) | 17.5 |
| Socioeconomic status, no. (%) | ||||
| Quintile 1 (lowest) | 5614 (24.1) | 5030 (24.3) | 584 (22.5) | 5.7 |
| Quintile 2 | 5563 (23.8) | 4982 (24.0) | 581 (22.4) | 5.4 |
| Quintile 3 | 4365 (18.7) | 3883 (18.7) | 482 (18.6) | 1.8 |
| Quintile 4 | 4041 (17.3) | 3568 (17.2) | 473 (18.2) | 1.3 |
| Quintile 5 (highest) | 3748 (16.1) | 3274 (15.8) | 474 (18.3) | 5.1 |
| Rural (community < 1000 people), no. (%) | 1764 (7.4) | 1425 (6.7) | 339 (12.4) | 19.4 |
| Primary care attachment (relational continuity),* no. (%) | ||||
| Infrequent | 2651 (11.1) | 2279 (10.7) | 372 (13.6) | 8.7 |
| Low | 3185 (13.3) | 2799 (13.2) | 386 (14.1) | 2.7 |
| Medium | 7021 (29.3) | 6211 (29.3) | 810 (29.6) | 0.7 |
| High | 11 097 (46.3) | 9929 (46.8) | 1168 (42.7) | 8.3 |
| Diabetes illness severity | ||||
| Baseline HbA1c, mean ± SD | 8.4 ± 2.0 | 8.4 ± 1.9 | 8.5 ± 2.1 | 7.6 |
| Proportion with sustained HbA1c > 9%, no. (%) | 5413 (22.6) | 4744 (22.4) | 669 (24.5) | 4.9 |
| Duration of diabetes, yr, mean ± SD | 8.9 ± 6.1 | 8.9 ± 6.0 | 9.1 ± 6.2 | 2.4 |
| Admissions to hospital or visits to EDs for diabetes-specific ACSC in year before visit,† mean ± SD | 0.35 ± 0.97 | 0.32 ± 0.86 | 0.53 ± 1.5 | 13.2 |
| Patients with 1 hospital or ED visit for diabetes-specific ACSC in year before visit,† no. (%) | 3888 (16.2) | 3354 (15.8) | 534 (19.5) | 5.8 |
| Patients with 2 or more hospital or ED visits for diabetes-specific ACSC in year before visit,† no. (%) | 1452 (6.1) | 1167 (5.5) | 285 (10.4) | 5.8 |
| Comorbidities | ||||
| CKD, no. (%) | 8993 (37.5) | 7897 (37.2) | 1096 (40.1) | 5.8 |
| More advanced CKD,‡ no. (%) | 1345 (15.0) | 1158 (14.7) | 187 (17.1) | 6.6 |
| 1 comorbidity only (including diabetes),§ no. (%) | 3848 (16.1) | 3343 (15.8) | 505 (18.5) | 13.2 |
| 2 comorbidities,§ no. (%) | 6063 (25.3) | 5474 (25.8) | 589 (21.5) | 10.1 |
| 3 or 4 comorbidities,§ no. (%) | 9572 (40.0) | 8558 (40.3) | 1014 (37.1) | 6.7 |
| ≥ 5 or more comorbidities,§ no. (%) | 4471 (18.7) | 3843 (18.1) | 628 (23.0) | 12.0 |
Note: ACSC = ambulatory care sensitive condition, CKD = chronic kidney disease, ED = emergency department, SD = standard deviation.
↵* Primary care attachment (also called relational continuity) categories are defined as infrequent (1 or 2 primary care visits), high (> 75% of patients’ 3 or more primary care visits made to the same physician), medium (50%–75% of 3 or more visits made to the same physician), and low (< 50% of visits made to any 1 primary care physician).
↵† Diabetes-specific ambulatory care sensitive conditions include coma, acidosis and hypoglycemia and no mention of complications for type 1, type 2, other specified and unspecified diabetes.
↵‡ More advanced CKD is defined as estimated glomerular filtration rate (eGFR) < 30 mL/min/1.73 m2, eGFR < 45 mL/min/1.73 m2 with moderate or severe albuminuria, or eGFR < 60 mL/min/1.73 m2 with severe albuminuria. Moderate albuminuria is defined as albumin-creatinine ratio (ACR) 30–300 mg/g, protein-creatinine ratio (PCR) 150–500 mg/g, urine dipstick (UDIP) 1+ and severe albuminuria is defined as ACR > 300 mg/g, PCR > 500 mg/g, UDIP ≥ 2+.
↵§ Comorbidities included diabetes, CKD and 28 other chronic conditions with validated administrative data algorithms.20