A Comparison of Primary Care and Traditional Internal Medicine Residents

The goal of this study is to identify objective differences between primary care and traditional medicine residents in clinical performance, continuity of care and utilization of resources. Specifically, this retrospective study will analyze the database collected by CLIMACS, the computer system at Cornell Internal Medicine Associates (CIMA). This system is used for clinical and administrative purposes; it manages and tracks patient's information and demographics, appointment booking, clinical diagnosis, prescriptions and medications, laboratory and radiology test, and consults. In our study, we will analyze a subset of the CLIMACS database from previous years.

Study Overview

Detailed Description

Three areas will be examined:

  1. Clinical performance
  2. Continuity of care
  3. Utilization of resources

Clinical performance will be assessed using Health Plan Employer data and Information Set (HEDIS) performance standards. These standards were developed for the purposes of quality assessment, and in our study we will examine the following HEDIS standards:

  1. Breast Cancer Screening- the proportion of women between the ages of 52 and 64 who have had a mammogram within a two year period.
  2. Cervical Cancer Screening- the proportion of women between the ages of 21 and 64 who had a Pap test in the preceding 3 years.
  3. Cholesterol Screening- the proportion of patients ages 20 to 39 and 40-59 who have had their cholesterol tested at least once in the past five years.
  4. Asthma admission rate- the proportion of asthmatics admitted to the hospital for the care of asthma per year.
  5. Diabetic Standards-

    1. Admission for cellulitis/ 1000 diabetics per year.
    2. Admission for diabetes/ 1000 diabetics per year.
    3. Inpatient days per 100 diabetics per year.
    4. Prevalence of ischemic heart disease.
    5. Prevalence of severe renal disease.
    6. Diabetics with >2 hemoglobin A1C drawn per year.

Continuity of Care will be assessed by 3 different indicators:

  1. The proportion of visits that are made to the designated primary care provider of the number of visits made.
  2. The proportion of missed appointments of the total number of appointments.
  3. The proportion of walk in visits of the total number of appointments.

Resource utilization will be assessed by examining the following:

  1. Number of lab test per year per patient.
  2. Number of specialty consults per year per patient.
  3. Hospital admission rates per patient per year.
  4. Cost to medications. Confidentiality will be maintained throughout the study. In clinical practice access to CLIMACS is limited to the medical providers and administrators by individuals access codes. Furthermore, our study will remove specific identifiers to maintain the anonymity of both the patients and residents.

Study Type

Observational

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • New York
      • New York, New York, United States, 10065
        • New York Presbyterian Hospital-Weill Medical College

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

21 years to 64 years (Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  1. Patients who are followed as outpatients by a Cornell affiliated internist at the Cornell Internal Medicine Associates (CIMA).
  2. Patients at New York Hospital who may or may not go on to be followed as outpatients at CIMA.

Exclusion Criteria:

Patients who elect not to participate in the study.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

What is the study measuring?

Primary Outcome Measures

Outcome Measure
To identify the differences between primary care and traditional medicine residents in clinical performance, continuity of care and utilization of resources.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

January 1, 1995

Study Completion

January 1, 2005

Study Registration Dates

First Submitted

September 20, 2005

First Submitted That Met QC Criteria

September 20, 2005

First Posted (Estimate)

September 22, 2005

Study Record Updates

Last Update Posted (Estimate)

April 3, 2008

Last Update Submitted That Met QC Criteria

April 2, 2008

Last Verified

March 1, 2008

More Information

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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