| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Article |
1 Center for Research Strategies and the Department of Family Medicine, University of Colorado Health Sciences Center, Denver, Colo
2 Department of Family Medicine, Case Western Reserve University, Cleveland, Ohio
3 Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio
4 Department of Sociology, Case Western Reserve University, Cleveland, Ohio
5 Ireland Comprehensive Cancer Center, University Hospitals of Cleveland and Case Western Reserve University, Cleveland, Ohio
6 Center for Research in Family Practice and Primary Care, Case Western Reserve University, Cleveland, Ohio
CORRESPONDING AUTHOR Paul A. Nutting, MD, MSPH Center for Research Strategies 225 E 16th Ave, Suite 1150 Denver, CO 80203 Paul.Nutting{at}CRSLLC.org
BACKGROUND Inconsistent findings on the value of continuity of care can stem from variability in its importance to different subsets of patients. We therefore examined the association among patient and visit characteristics and extent to which the patient valued continuity of care (PVC). We hypothesized that continuity would be more important to patients who are older, sicker, and female, who have established a relationship with their physician, and whose visit addresses more complex problems.
METHODS A study of 4,454 consecutive outpatient visits to 138 community-based family physicians used a 3-item measure (
= 0.67) of PVC. The patient’s report of (1) the adequacy of primary care for the visit and (2) satisfaction with the physician on that visit was assessed with multiple measures. Analyses examined the associations among PVC and patient-reported satisfaction with the physician and adequacy of the visit.
RESULTS Extremes of age, female sex, less education, Medicare and Medicaid insurance, number of chronic conditions and medications, number of visits to the practice, and worse self-reported health status were associated with higher value placed on continuity (P <.001 for all except sex, where P = .015). Patients who value continuity and did not see a regular physician rated adequacy of the visit lower (for 7 attributes of the visit) than those seeing their own physician. Satisfaction with the physician for the visit was greatest among patients who value continuity and saw their regular physician.
CONCLUSIONS Continuity of physician care is associated with more positive assessments of the visit and appears to be particularly important for more vulnerable patients. Health care systems and primary care practices should devote additional effort to maintaining a continuity relationship with these vulnerable patients.
Key Words: Primary health care • physicians • family • continuity of patient care • primary care physicians • quality of care
This article has been cited by other articles:
|
|
 |
|
  T. C. Rosenthal The Medical Home: Growing Evidence to Support a New Approach to Primary Care J Am Board Fam Med, September 1, 2008; 21(5): 427 - 440. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. E. DeVoe, L. S. Wallace, N. Pandhi, R. Solotaroff, and G. E. Fryer Jr Comprehending Care in a Medical Home: A Usual Source of Care and Patient Perceptions about Healthcare Communication J Am Board Fam Med, September 1, 2008; 21(5): 441 - 450. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Guthrie, J. W Saultz, G. K Freeman, and J. L Haggerty Continuity of care matters BMJ, August 7, 2008; 337(aug07_1): a867 - a867. [Full Text]
|
|
|
|
 |
|
 L. L. Berry, J. T. Parish, R. Janakiraman, L. Ogburn-Russell, G. R. Couchman, W. L. Rayburn, and J. Grisel Patients' Commitment to Their Primary Physician and Why It Matters Ann. Fam. Med, January 1, 2008; 6(1): 6 - 13. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. G. O'Malley and A. S. O'Malley Studies Comparing Quality of Care by Specialty: Valid, Relevant, or Neither? Arch Intern Med, January 8, 2007; 167(1): 8 - 9. [Full Text] [PDF]
|
|
|
|
|
|
N. Pandhi and J. W. Saultz Patients' perceptions of interpersonal continuity of care. J Am Board Fam Med, July 1, 2006; 19(4): 390 - 397. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Stokes, C. Tarrant, A. G. Mainous III, H. Schers, G. Freeman, and R. Baker Continuity of Care: Is the Personal Doctor Still Important? A Survey of General Practitioners and Family Physicians in England and Wales, the United States, and the Netherlands Ann. Fam. Med, July 1, 2005; 3(4): 353 - 359. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. A. Hall, R. A. Peeples, and R. W. Lord Jr Liability Implications of Physician-Directed Care Coordination Ann. Fam. Med, March 1, 2005; 3(2): 115 - 121. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Glynn, M Byrne, J Newell, and A. Murphy The effect of health status on patients' satisfaction with out-of-hours care provided by a family doctor co-operative Fam. Pract., December 1, 2004; 21(6): 677 - 683. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. D. Morgan, M. Pasquarella, and J. R. Holman Continuity of Care and Patient Satisfaction in a Family Practice Clinic J Am Board Fam Med, September 1, 2004; 17(5): 341 - 346. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Kerse, S. Buetow, A. G. Mainous III, G. Young, G. Coster, and B. Arroll Physician-Patient Relationship and Medication Compliance: A Primary Care Investigation Ann. Fam. Med, September 1, 2004; 2(5): 455 - 461. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. C. Stange Provocative Questions Ann. Fam. Med, January 1, 2004; 2(1): 84 - 86. [Full Text] [PDF]
|
|
|
|
|
|
K. C. Stange In this Issue: Continuity of Care Ann. Fam. Med, September 1, 2003; 1(3): 130 - 131. [Full Text] [PDF]
|
|
|
|
|
|
D. A. Christakis Continuity of Care: Process or Outcome? Ann. Fam. Med, September 1, 2003; 1(3): 131 - 133. [Full Text] [PDF]
|
|
Read all TRACK Comments
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
