Continuity of care and diabetes mellitus management in an internal medicine residency program

The advantages of the continuity of care in residency training have yet to be established. We evaluated the association between continuity of care and diabetes quality of care in an internal medicine residency program with two clinics, a "primary care clinic (non-continuity clinic)" and a "medicine continuity clinic (continuity clinic)." Study subjects were those who: 1) had visited the non-continuity clinic or continuity clinic between July 2005 and June 2006, 2) were aged 40 to 75, and 3) have diabetes (N=423). Although more subjects in continuity clinic had proteinuria testing and ophthalmologist visit than subjects in non-continuity clinic, there was no significant difference in any process measures between the two clinics after multiple adjustments. Health outcomes did not differ between the continuity clinic and non-continuity clinic before and after multiple adjustments. The concept of continuity needs to be revisited with respect to the processes and outcomes of diabetes care.