A cross-sectional study of community-level physician retention and diabetes management in rural Ontario

Objective — To examine the impact of community-level physician retention on the quality of diabetes care in rural Ontario.

Methods — Using administrative data, we compared diabetes quality of care. We defined retention as the proportion of physicians in a community from one year to the next. We grouped retention level by tertile and added a category for communities with no physician.

Results — Residents of high retention communities were more likely to have HbA1C (1.10;95%CI:1.06-1.14) and LDL testing (1.17;95%CI:1.13-1.22), but less likely to have UACR testing (0.86;95%CI:0.83-0.89) or receive ACE/ARBs (0.91;95%CI:0.86-0.95) or statins (0.91;95%CI:0.87-0.96) than low retention communities. Communities with no residing physician had care that was equivalent to or better than high-retention communities.

Discussion — Community-level physician retention, based on a two-year time frame, was significantly related.