Further evaluating the acceptability of group visits in an uninsured or inadequately insured patient population with uncontrolled type 2 diabetes

Abstract

Purpose: The purpose of the study was to evaluate perceptions of care delivered through group visits to disadvantaged patients with type 2 diabetes.

Methods: One hundred eighty-six patients with uncontrolled type 2 diabetes were randomly assigned to receive care in group visits or usual care for 12 months. Their perceptions of the care they received were measured at baseline and 6 and 12 months by the Primary Care Assessment Tool (PCAT), the Diabetes-Specific Locus of Control (DLC) survey, and the Trust in Physician Scale (TPS).

Results: Compared to patients in usual care, group visit patients' PCAT scores were higher in the domains of ongoing care (P = .001), community orientation (P < .0001), and cultural competence (P = .022). In addition, group patients had higher scores for the Powerful-Other Health Professional subscale of the DLC survey (P = .010).

Conclusions: Patients assigned to group visits had generally more positive perceptions about their care in the areas of ongoing care, community orientation of care, and cultural competence of care than did those in usual care. The perception that one's health professional is powerful, however, has been associated with a reluctance of patients to make medication changes on their own in previous studies. These findings suggest the need for modification in the way that group visits are conducted to empower and activate patients while still delivering continuous, culturally competent, and community-oriented care.