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A Comparison of Primary Care and Traditional Internal Medicine Residents

21 Years
64 Years
Not Enrolling
Breast Cancer Screening, Cervical Cancer Screening, Cholesterol Screening, Asthma Admission Rate, Diabetes Management

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Trial Information

A Comparison of Primary Care and Traditional Internal Medicine Residents

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.

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.

Type of Study:


Study Design:

Time Perspective: Retrospective

Outcome Measure:

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

Principal Investigator

Mary E Charlson, MD

Investigator Role:

Principal Investigator

Investigator Affiliation:

Weill Medical College of Cornell University


United States: Institutional Review Board

Study ID:

9510000400 (Formerly 1095-071)



Start Date:

January 1995

Completion Date:

January 2005

Related Keywords:

  • Breast Cancer Screening
  • Cervical Cancer Screening
  • Cholesterol Screening
  • Asthma Admission Rate
  • Diabetes Management
  • Clinical performance
  • Continuity of care
  • Utilization of resources
  • Breast Neoplasms
  • Uterine Cervical Neoplasms



New York Presbyterian Hospital-Weill Medical College New York, New York  10065