{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T01:42:27Z","timestamp":1777858947060,"version":"3.51.4"},"reference-count":23,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Prim Care Community Health"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>There has been a trend toward hospital systems and insurers acquiring privately owned physician practices and subsequently converting them into vertically integrated practices. The purpose of this study is to observe whether this change in ownership of a medical practice influences adherence to clinical guidelines for the management of type 1 and type 2 diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This is an observational study using pooled cross-sectional data (2014-2016 and 2018-2019) from the National Ambulatory Medical Care Survey, a nationally representative probability sample of US office-based physician visits. A total of 7499 chronic routine follow ups and preventative care visits to non-integrated (solo and group physician practices) and integrated practices were analyzed to see whether guideline concordant care was provided. Measures included 7 services that are recommended annually for individuals with type 1 and type 2 diabetes (HbA1c, lipid panel, serum creatinine, depression screening, influenza immunization, foot examination, and BMI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Compared to non-integrated physician practices, vertically integrated practices had higher rates of hemoglobin A1C testing (odds ratio 1.58 [95% CI 1.07-2.33], P\u2009&lt;\u2009.05), serum creatine testing (odds ratio 1.53 [95% CI 1.02-2.29], P\u2009&lt;\u2009.05), foot examinations (odds ratio 2.03 [95% CI 0.98-4.22], P\u2009=\u2009.058), and BMI measuring (odds ratio 1.54 [95% CI 0.99-2.39], P\u2009=\u2009.054). There was no significant difference in lipid panel testing, depression screenings, or influenza immunizations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Our results show that integrated medical practices have a higher adherence to diabetes practice guidelines than non-integrated practices. However, rates of services provided regardless of ownership were low.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21501319241259685","type":"journal-article","created":{"date-parts":[[2024,6,6]],"date-time":"2024-06-06T03:17:12Z","timestamp":1717643832000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of Practice Ownership and Integration of Health Services on Adherence to Diabetes Guidelines"],"prefix":"10.1177","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-3618-4432","authenticated-orcid":false,"given":"Nick","family":"Kostrubsky","sequence":"first","affiliation":[{"name":"Florida State University, Tallahassee, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey S.","family":"Harman","sequence":"additional","affiliation":[{"name":"Florida State University, Tallahassee, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,6,6]]},"reference":[{"key":"bibr1-21501319241259685","doi-asserted-by":"publisher","DOI":"10.1016\/S0891-8422(03)00082-X"},{"key":"bibr2-21501319241259685","unstructured":"Centers for Disease Control and Prevention. What is Diabetes? 2024. Accessed August 8, 2023. https:\/\/www.cdc.gov\/diabetes\/basics\/diabetes.html"},{"key":"bibr3-21501319241259685","volume":"362","author":"Xu G","year":"2018","journal-title":"BMJ"},{"key":"bibr4-21501319241259685","doi-asserted-by":"publisher","DOI":"10.2337\/diaclin.26.2.77"},{"key":"bibr5-21501319241259685","doi-asserted-by":"publisher","DOI":"10.15212\/FMCH.2018.0121"},{"key":"bibr6-21501319241259685","unstructured":"Agency for Healthcare Research and Quality. National Healthcare Quality and Disparities Report. 2018. Accessed August 8, 2023. https:\/\/www.ahrq.gov\/research\/findings\/nhqrdr\/chartbooks\/effectivetreatment\/diabetes.html"},{"key":"bibr7-21501319241259685","doi-asserted-by":"publisher","DOI":"10.1177\/23821205221076659"},{"key":"bibr8-21501319241259685","doi-asserted-by":"publisher","DOI":"10.1186\/s40842-019-0084-9"},{"key":"bibr9-21501319241259685","unstructured":"AHA Center for Health Innovation. Evolving Physician-Practice Ownership Models. 2020. Accessed August 7, 2023. https:\/\/www.aha.org\/system\/files\/media\/file\/2020\/02\/Market_Insights_MD_Ownership_Models.pdf"},{"key":"bibr10-21501319241259685","unstructured":"Physicians Advocacy Institute. Updated Physician Practice Aquation Study: National and Regional Changes in Physician Employment 2012-2018. 2019. Accessed August 7, 2023. https:\/\/www.physiciansadvocacyinstitute.org\/Portals\/0\/assets\/docs\/021919-Avalere-PAI-Physician-Employment-Trends-Study-2018-Update.pdf?ver=2019-02-19-162735-117"},{"key":"bibr11-21501319241259685","unstructured":"Physicians Advocacy Institute. PAI-Avalere Report on Physician Employment Trends and Practice Aquations in 2019-2021: Key Research Findings. 2022. Accessed August 7, 2023. https:\/\/www.physiciansadvocacyinstitute.org\/Portals\/0\/assets\/docs\/PAI-Research\/Key%20Findings%20-%20Physician%20Employment%20Trends%20Study%202019-21%20Key%20Findings.pdf?ver=mDlkytCMEj2KIs___eFTdw%3d%3d"},{"key":"bibr12-21501319241259685","doi-asserted-by":"publisher","DOI":"10.2337\/dc22-2372"},{"issue":"3","key":"bibr13-21501319241259685","first-page":"172","volume":"22","author":"Bishop TF","year":"2016","journal-title":"Am J Manag Care"},{"key":"bibr14-21501319241259685","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2013.6886"},{"key":"bibr15-21501319241259685","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2009.0388"},{"key":"bibr16-21501319241259685","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.12450"},{"key":"bibr17-21501319241259685","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.12242"},{"key":"bibr18-21501319241259685","unstructured":"Centers for Disease Control and Prevention. About the Ambulatory Health Care Surveys. 2021. Accessed August 10, 2023. https:\/\/www.cdc.gov\/nchs\/ahcd\/about_ahcd.htm"},{"issue":"1","key":"bibr19-21501319241259685","volume":"46","author":"ElSayed NA","year":"2023","journal-title":"Diabetes Care"},{"key":"bibr20-21501319241259685","doi-asserted-by":"publisher","DOI":"10.1016\/j.eprac.2022.08.002"},{"key":"bibr21-21501319241259685","doi-asserted-by":"publisher","DOI":"10.2147\/IJGM.S333501"},{"key":"bibr22-21501319241259685","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.25.11.1946"},{"key":"bibr23-21501319241259685","unstructured":"Barney A. Improving adherence to annual diabetes guidelines in rural primary care. Culminating Experience Projects. 309. 2023. 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