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Table 1 Characteristics of VA Patients with Diabetes by Continuity of Care in Primary Care Providera Type Assigned

From: Interpersonal continuity of primary care of veterans with diabetes: a cohort study using electronic health record data

Category Switched Providers n = 146,500 Same Provider n = 509,868 Total n = 656,368
Patient-level factors
 Male 140,638 (96.0) 492,869 (96.7) 633,507 (96.5)
 Female 5862 (4.0) 16,999 (3.3) 22,861 (3.5)
Age Group
 Less Than 40 2052 (1.40) 4862 (0.95) 6914 (1.05)
 40 to Less Than 65 80,264 (54.8) 261,109 (51.2) 341,373 (52.0)
 65 to Less Than 80 52,682 (36.0) 196,840 (38.6) 249,522 (38.0)
 80 and Over 11,502 (7.85) 47,057 (9.23) 58,559 (8.92)
Race
 White 103,597 (70.7) 363,036 (71.2) 466,633 (71.1)
 American Indian 1289 (0.88) 3678 (0.72) 4967 (0.76)
 Asian 918 (0.63) 2832 (0.56) 3750 (0.57)
 Black 26,975 (18.4) 91,991 (18.0) 118,966 (18.1)
 Native Hawaiian 1599 (1.09) 5596 (1.10) 7195 (1.10)
 Unknown or Missing 12,122 (8.27) 42,735 (8.38) 54,857 (8.36)
 Hispanic 8561 (5.84) 24,157 (4.74) 32,718 (4.98)
Marital Status
 Currently Married 84,329 (57.6) 308,274 (60.5) 392,603 (59.8)
 Never Married 17,016 (11.6) 54,421 (10.7) 71,437 (10.9)
 Previously Married 44,772 (30.6) 145,689 (28.6) 190,461 (29.0)
 Unknown Marital Status 383 (0.26) 1484 (0.29) 1867 (0.28)
 Homeless at Any Time During Year 4549 (3.11) 8711 (1.71) 13,260 (2.02)
Copay Status
 No Copay Due to Disability 81,123 (55.4) 278,359 (54.6) 359,482 (54.8)
 No Copay Due to Low Income 40,864 (27.9) 133,272 (26.1) 174,136 (26.5)
 Must Pay Copay 22,502 (15.4) 91,157 (17.9) 113,659 (17.3)
 Copay Status Unknown 2011 (1.37) 7080 (1.39) 9091 (1.39)
Mental Health Diagnoses
 Mood Disorder 39,135 (26.7) 121,321 (23.8) 160,456 (24.4)
 Post-Traumatic Stress Disorder 22,683 (15.5) 72,896 (14.3) 95,579 (14.6)
 Dementia 4957 (3.38) 15,236 (2.99) 20,193 (3.08)
 Substance Abuse 13,689 (9.34) 38,160 (7.48) 51,849 (7.90)
 Other Mental Health Diagnosis 8782 (5.99) 30,004 (5.88) 38,786 (5.91)
Diagnostic Cost Group (DCG) Score Category
 Less Than or Equal to 0.5 69,654 (47.5) 260,010 (51.0) 329,664 (50.2)
 Greater Than 0.5 to 1 25,123 (17.1) 86,700 (17.0) 111,823 (17.0)
 Greater Than 1 to 1.5 19,313 (13.2) 64,932 (12.7) 84,245 (12.8)
 Greater Than 1.5 to 2 11,228 (7.66) 35,519 (6.97) 46,747 (7.12)
 Greater Than 2 21,182 (14.5) 62,707 (12.3) 83,889 (12.8)
Distance from VHA Primary Care Clinic
 Less Than 5 Miles 31,941 (21.8) 119,774 (23.5) 151,715 (23.1)
 5 to Less Than 25 Miles 71,412 (48.7) 265,553 (52.1) 336,965 (51.3)
 25 to Less Than 50 Miles 24,976 (17.0) 83,394 (16.4) 108,370 (16.5)
 50 Miles and Over 17,018 (11.6) 37,448 (7.34) 54,466 (8.30)
 Missing 1153 (0.79) 3699 (0.73) 4852 (0.74)
 Baseline BMI
 Less Than 18.5 363 (0.25) 1152 (0.23) 1515 (0.23)
 18.5 to Less Than 25 13,566 (9.26) 47,100 (9.24) 60,666 (9.24)
 25 to Less Than 30 42,293 (28.9) 149,814 (29.4) 192,107 (29.3)
 30 to Less Than 35 46,015 (31.4) 160,415 (31.5) 206,430 (31.5)
 35 and Above 44,263 (30.2) 151,387 (29.7) 195,650 (29.8)
Number of PC Visits
 1 PC Visit 39,830 (27.2) 103,854 (20.4) 143,684 (21.9)
 2 PC Visits 38,382 (26.2) 192,864 (37.8) 231,246 (35.2)
 3 PC Visits 32,305 (22.1) 104,846 (20.6) 137,151 (20.9)
 4 or More PC Visits 35,983 (24.6) 108,304 (21.2) 144,287 (22.0)
 Pharmacy Fill of Insulin 65,784 (44.9) 216,765 (42.5) 282,549 (43.0)
 Patient Had Same Zip Code in FY12 and FY13 127,158 (86.8) 478,420 (93.8) 605,578 (92.3)
Provider-level factors
 Assigned Provider Type in FY12
 Physician 104,395 (71.3) 394,959 (77.5) 499,354 (76.1)
 Nurse Practitioner 25,616 (17.5) 79,588 (15.6) 105,204 (16.0)
 Physician Assistant 10,185 (6.95) 30,798 (6.04) 40,983 (6.24)
 Physician Resident 6304 (4.30) 4523 (0.89) 10,827 (1.65)
Assigned Provider Type in FY13
 Physician 87,706 (59.9) 395,286 (77.5) 482,992 (73.6)
 Nurse Practitioner 20,564 (14.0) 79,464 (15.6) 100,028 (15.2)
 Physician Assistant 7178 (4.90) 30,716 (6.02) 37,894 (5.77)
 Physician Resident 5051 (3.45) 4402 (0.86) 9453 (1.44)
 Unable to Assign 26,001 (17.7)   26,001 (3.96)
 Provider Turnover from Station 24,512 (16.7) 8746 (1.72) 33,258 (5.07)
Facility-level factors
 Endocrinology Referral Capacityb 70,437 (48.1) 238,805 (46.8) 309,242 (47.1)
 Rural Urban Commuting Area Status
 Metropolitan Area Core 106,700 (72.8) 377,339 (74.0) 484,039 (73.7)
 Metropolitan Area Core - Remaining Levels 16,423 (11.2) 62,616 (12.3) 79,039 (12.0)
 Micropolitan Area Core 18,003 (12.3) 53,501 (10.5) 71,504 (10.9)
 Small Town or Rural 5374 (3.67) 16,412 (3.22) 21,786 (3.32)
State-level factors
 Percent of Primary Care Physicians Who Work With NPs/PAs
 Lowest Tertile 78,653 (53.7) 284,992 (55.9) 363,645 (55.4)
 Middle Tertile 38,373 (26.2) 133,094 (26.1) 171,467 (26.1)
 Highest Tertile 29,474 (20.1) 91,782 (18.0) 121,256 (18.5)
Nurse Practitioner Scope of Practice Regulations
 Least Restrictive 23,738 (16.2) 69,747 (13.7) 93,485 (14.2)
 Moderately Restrictive 22,697 (15.5) 79,056 (15.5) 101,753 (15.5)
 Most Restrictive 100,065 (68.3) 361,065 (70.8) 461,130 (70.3)
Physician Assistant Scope of Practice Regulations
 Least Restrictive 20,774 (14.2) 69,521 (13.6) 90,295 (13.8)
 Moderately Restrictive 36,532 (24.9) 113,202 (22.2) 149,734 (22.8)
 Most Restrictive 89,194 (60.9) 327,145 (64.2) 416,339 (63.4)
VISN-LEVEL factors
 Region
  Northeast 16,522 (11.3) 75,920 (14.9) 92,442 (14.1)
  West 32,865 (22.4) 91,014 (17.9) 123,879 (18.9)
  Midwest 31,983 (21.8) 116,774 (22.9) 148,757 (22.7)
  South 65,130 (44.5) 226,160 (44.4) 291,290 (44.4)
  1. Data for patient-level variables are from the Veterans Administration electronic health record files. Other data sources are described in the Methods section
  2. aPrimary care provider (PCP) is assigned as the physician, NP, or PA seen most during FY 2012 and 2013
  3. bEndocrinology referral capacity is defined as either present (endocrinology or other diabetes mellitus specialty clinics provided 500 or more visits to cohort patients in FY12) or absent (fewer than 500 visits to cohort patients)