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Research ArticleOriginal Articles

Provider Continuity in Family Medicine: Does It Make a Difference for Total Health Care Costs?

Jan M. De Maeseneer, Lutgarde De Prins, Christiane Gosset and Jozef Heyerick
The Annals of Family Medicine September 2003, 1 (3) 144-148; DOI: https://doi.org/10.1370/afm.75
Jan M. De Maeseneer
MD
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Lutgarde De Prins
MA
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Christiane Gosset
MD
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Jozef Heyerick
MD
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Article Figures & Data

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    Table 1.

    Description of the Research Population by Provider Continuity in Family Medicine

    Variable1 Family Physician (n = 2,285)> 1 Family Physician (n = 1,849)P Value
    MOS SF-36 = Medical Outcomes Study 36-Item Short Form Health Survey (SF-36).
    * Higher score means a better condition.
    Age, mean years6968 .140
    Sex: female, % (n)50 (1,145)54 (992) .024
    Region: in Liège, % (n)44 (1,011)55 (1,019)<.001
    Living situation: alone, % (n)29 (653)28 (523) .890
    Education: higher secondary, % (n)23 (530)22 (413) .526
    Locus of control: internal, % (n)48 (1,101)47 (867) .416
    Income: difficulties, % (n)16 (360)20 (367) .001
    Environment: urban, % (n)16 (353)19 (346) .005
    Health insurance company: B, % (n)48 (1,095)55 (1,015)<.001
    Chronic disease: > 1, % (n)53 (1,216)60 (1,118)<.001
    MOS SF-36 dimensions*
        Physical functioning65 (± 30)60 (± 33)<.001
        Social functioning80 (± 26)75 (± 28)<.001
        Role limitations (physical)67 (± 42)62 (± 43)<.001
        Role limitations (emotional)79 (± 37)74 (± 40)<.001
        Mental health69 (± 21)64 (± 22)<.001
        Energy58 (± 23)53 (± 24)<.001
        Pain68 (± 28)62 (± 30)<.001
        General health58 (± 20)54 (± 23)<.001
        Change in health status46 (± 18)44 (± 20)<.001
    1 or more specialist consultations, %7785<.001
    • View popup
    Table 2.

    Total Health Care Cost (Median Scores in Euros [ε]) in 1994 and 1995 for Different Groups in Relation to Provider Continuity

    Determinants1 Family Physician (n = 2,285) ε (n)>1 Family Physician (n = 1,849) ε (n)
    *Kruskal-Wallis test.
    † Mann-Whitney test.
    Age, years
        45-64218 (690)324 (641)
        65-74329 (804)524 (580)
        75+435 (791)970 (627)
        P value*<.001<.001
    Sex
        Men297 (1,140)438 (857)
        Women338 (1,145)581 (992)
        P value†.029.07
    Region
        Aalst281 (1,274)462 (830)
        Liège351 (1,011)561 (1,019)
        P value†.009.418
    Living situation
        Alone393 (653)775 (523)
        Not alone290 (1,627)440 (1,317)
        P value†<.001<.001
    Education
        Lower secondary or less328 (1,738)585 (1,422)
        Higher secondary or more288 (530)374 (413)
        P value†.002<.001
    Health locus of control
        Not internal366 (1,184)422 (867)
        Internal278 (1,101)645 (982)
        P value†<.001<.001
    Income
        No difficulties308 (1,907)462 (1,470)
        Difficulties398 (360)766 (367)
        P value†.002<.001
    Health insurance company
        A320 (1,190)487 (834)
        B318 (1,095)535 (1,015)
        P value†.184.282
    Environment
        (Semi) rural306 (1,886)487 (1,463)
        Urban399 (353)626 (346)
        P value†.010.014
    Physical functioning
        ≤ 80 (bad)407 (1,363)761 (1,166)
        >80 (good)210 (896)275 (655)
        P value†<.001<.001
    Mental functioning
        ≤ 80 (bad)353 (1,542)604 (1,385)
        > 80 (good)241 (705)337 (450)
        P value†<.001<.001
    Multiple morbidity
        0 or 1 chronic disease219 (1,069)295 (731)
        > 1 chronic disease425 (1,216)782 (1,118)
        P value†<.001<.001
    • View popup
    Table 3.

    Provider Continuity (0/1) in a Multivariate Approach With Total Health Care Cost (Logarithmic Transformation) as the Dependent Variable: Standardized Regression Coefficientsβ

    Explaining VariablesStandardized Regression Coefficient βP Value
    R227.6%
    Older age.086< .001
    Sex (male)−.036 .008
    Health locus of control: internal−.030 .029
    Physical functioning−.1568< .001
    Mental functioning−.056< .001
    Multiple morbidity.116< .001
    Number of regular encounters.296< .001
    Provider continuity−.105< .001
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The Annals of Family Medicine: 1 (3)
The Annals of Family Medicine: 1 (3)
Vol. 1, Issue 3
1 Sep 2003
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Provider Continuity in Family Medicine: Does It Make a Difference for Total Health Care Costs?
Jan M. De Maeseneer, Lutgarde De Prins, Christiane Gosset, Jozef Heyerick
The Annals of Family Medicine Sep 2003, 1 (3) 144-148; DOI: 10.1370/afm.75

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Provider Continuity in Family Medicine: Does It Make a Difference for Total Health Care Costs?
Jan M. De Maeseneer, Lutgarde De Prins, Christiane Gosset, Jozef Heyerick
The Annals of Family Medicine Sep 2003, 1 (3) 144-148; DOI: 10.1370/afm.75
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