When scientists compared the number of primary care visits to specialist visits for diabetic individuals in a recent Washington, D.C., study, they discovered that having additional co-existing conditions increases patients' odds of seeing a specialist.
Researchers at the Robert Graham Center for Policy Studies in Family Medicine and Primary Care recently released the results of a study titled "Complexity of ambulatory care visits of patients with diabetes as reflected by diagnoses per visit," designed to measure the "complexity" of diabetic patient visits based on the number of conditions reported within the span of one appointment.
While 48 percent of all diabetic patients’ appointments were made with primary care doctors when patients reported no other chronic conditions, the number dropped incrementally for each additional complication in the patient’s profile. The report indicated that specialist visits — chosen 70 percent of the time — were likely to involve only one diagnosis, but that multiple diagnoses were more frequent with primary care appointments.
"In contrast, multiple diagnoses were more common in visits to primary care physicians," researchers said in the study. "Overall, complexity of the office visit, as reflected by the number of visit diagnoses reported, is found to be higher for primary care physicians than for subspecialist physicians."
The study involved 4,500 patients with diabetes, of an average age of 61. The results suggested that patients tend to rely on primary care professionals to manage their chronic health issues rather than on specialists.
"When patients are thinking about their own individual health conditions, they think of the specialist as the provider — but for their overall health, the perception is that the primary care physician is treating all of their conditions," Miranda Moore, the study’s lead author, said. "The current fee-for-service reimbursement model is based on volume of care, not necessarily on multiple dimensions of complexity related to the cognitive ability needed to provide whole-person care."