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Impact of Physician Specialty Mix on the Outcomes of Patients Dually Diagnosed With Diabetes and Compensated Cirrhosis

Liver cirrhosis, an irreversible chronic condition, was the 11th leading cause of death in the U.S. in 2012 (1). Up to 70% of patients with compensated cirrhosis have coexisting diabetes (2). Previous studies found that patients dually diagnosed with diabetes and compensated cirrhosis are often managed by primary care physicians (PCP), although the percentage who also visit specialists such as gastroenterologists (GI) and endocrinologists (ENDO) is increasing (3). Whether the mix of physician specialties visited is associated with major health events among these dually diagnosed patients is unknown. Therefore, this study investigates whether physician mix affects outcomes of patients dually diagnosed with compensated cirrhosis and diabetes. The study was reviewed and approved by the University of North Carolina at Chapel Hill Institutional Review Board.

This retrospective study analyzed MarketScan Commercial Claims and Encounters and Medicare Supplemental databases (2000–2013). A total of 18,359 adults (aged ≥18 years) with ICD-9 codes indicating both diabetes and compensated cirrhosis were classified into one of …