Interdisciplinary primary care team expertise and diabetes care management

Abstract

Background: Interdisciplinary primary care team expertise can aid patient self management of type 2 diabetes, but small community health centers (CHCs) may not have the volume to consistently provide interprofessional care. We examine whether care team role expertise is associated with patients' experiences of chronic care and whether the relationship is stronger for small CHC sites. Methods: Surveys of 1277 adults with diabetes (2012; response rate = 47%) that assessed nonphysician team roles involved in managing their chronic care, including community health workers, diabetes educators, nutritionists, pharmacists, mental health providers, and other general staff, were integrated with clinical and administrative data from 14 CHCs. Random effects regression models estimated the association of team expertise, CHC size, and 1) patients' experiences of chronic care; and 2) hemoglobin A1c control, controlling for patient comorbidities, sex, race/ethnicity/primary language, age, and insurance coverage. Results: Care teams with community health workers (b = 7.67, P