Article Figures & Data
Tables
Characteristic PVC Mean (SD) or r P Value Patient age, years 0–6 (n = 258) 4.48 (0.61) <.001 7–12 (n = 146 4.32 (0.81) 13–18 (n = 156) 4.25 (0.85) 19–39 (n = 657) 4.19 (0.80) 40–64 (n = 974) 4.46 (0.70) ≥65 (n = 557) 4.67 (0.56) Patient sex Male (n = 1,049) 4.38 (0.73) .015 Female (n = 1,707) 4.44 (0.73) Patient race White (n = 2,501) 4.42 (0.73) .326 Not white (n = 262) 4.38 (0.77) Educational level attained High school graduate or less (n = 1,014) 4.51 (0.70) <.001 More than high school (n = 1,155) 4.35 (0.73) Number of visits to practice in last year 0.20 <.001 Usual provider continuity index 0.14 <.001 Index physician is patient’s regular doctor No (n = 232) 4.00 (0.86) <.001 Yes (n = 2,459) 4.46 (0.70) Years as a patient of the index physician 0.22 <.001 Insurance Medicare (n = 594) 4.66 (0.58) <.001 Undeterminable (n = 19) 4.58 (0.49) Unclassified (n = 24) 4.47 (0.65) Medicaid (n = 146) 4.45 (0.71) Other (n = 32) 4.43 (0.67) None (n = 185) 4.37 (0.87) Managed care (n = 1,087) 4.36 (0.73) Fee for service (n = 676) 4.29 (0.76) Number of medications taken 0.19 <.001 Number of chronic illnesses 0.20 <.001 Self-reported health status In general −0.09 <.001 Health problems limit daily activities −0.08 <.001 Bothered by emotional problems −0.01 .576 Amount of bodily pain −0.07 <.001 Difficulty doing everyday work −0.08 <.001 Summary measure −0.09 <.001 Components of Primary Care Instrument Accumulated knowledge 0.40 <.001 Coordination of care 0.45 <.001 Interpersonal communication 0.39 <.001 - Table 2.
Patient’s Assessment of the Adequacy of Their Primary Care Visit as a Function of Valuing Continuity of Care and Seeing Their Regular Physician
Value of Continuity Main Effects Interaction Assessment of Visit Low Medium High Value of Continuity Regular Doctor Value of Continuity with Regular Doctor Note: For the above comparisons, the 6 cell sizes for each comparison ranged from 32–1,167. Expectations met Regular doctor 4.08 4.37 4.63 <.001 <.001 .06 Not regular doctor 3.86 4.19 4.14 Things I wanted to bring up but could not Regular doctor 2.05 1.75 1.42 <.001 .48 .36 Not regular doctor 1.95 1.98 1.55 Doctor addressed my main concern Regular doctor 4.34 4.67 4.87 <.001 .006 .32 Not regular doctor 4.29 4.50 4.65 Satisfaction with physician Regular doctor 4.11 4.36 4.66 <.001 <.001 <.001 Not regular doctor 3.96 4.10 4.04 Physician’s accumulated knowledge of the patient Regular doctor 3.10 3.48 3.93 <.001 <.001 <.001 Not regular doctor 2.31 2.35 2.35 Coordination of care Regular doctor 3.30 3.78 4.32 <.001 <.001 .004 Not regular doctor 2.92 3.01 3.30 Interpersonal communication Regular doctor 3.95 4.31 4.63 <.001 <.001 <.001 Not regular doctor 3.67 3.76 3.79 - Table 3.
Regression Models Examining Patient Characteristics, Visit Characteristics, Seeing Regular Physician, and Patient’s Valuing Continuity as Predictors of Patient Rating of Satisfaction with the Physician Visit
Characteristics Model 1 Model 2* Model 3 † β SE(β) P Value β SE(β) P Value β SE(β) P Value * Model 2 includes visit characteristics (length and number of problems). † Model 3 Includes visit characteristics and interaction of value of continuity and regular physician. ‡ Reference category for categorical variables. § Reference category is male. Patient characteristics Age, years 13–39‡ 0–12 .042 .044 .340 .051 .044 .251 −.001 .045 .984 40 and older .179 .033 < .001 .156 .034 <.001 .080 .034 .019 Sex§ .052 .027 .055 .037 .027 .178 .018 .028 .514 Health status .086 .018 < .001 .103 .018 <.001 .084 .019 < .001 Number of visits in previous year .009 .005 .090 .013 .005 .020 .000 .006 .998 Insurance type Fee for service‡ Managed care −.029 .034 .387 −.032 .034 .341 −.053 .034 .120 Medicare .071 .042 .087 .071 .042 .092 −.006 .044 .901 Medicaid .047 .065 .471 .071 .065 .275 .030 .066 .649 None −.025 .056 .663 −.037 .057 .516 −.096 .059 .103 Other −.038 .078 .623 −.012 .078 .878 −.075 .085 .374 Visit characteristics Length of visit .013 .002 < .001 .013 .003 <.001 Number of problems addressed .024 .013 .062 .010 .013 .443 Continuity Visit made to regular physician −.555 .231 .017 Patient value of continuity .105 .052 .044 Interaction of patient value of continuity with regular physician .207 .056 <.001 Model R2 .025 .042 .148
In this issue
Jump to section
Related Articles
Cited By...
- Convenience or Continuity: When Are Patients Willing to Wait to See Their Own Doctor?
- Improving personal continuity in general practice: a focus group study
- Optimising personal continuity for older patients in general practice: a cluster randomised stepped wedge pragmatic trial
- Dutch GPs perspectives on addressing obesity: a qualitative study
- Optimising personal continuity: a survey of GPs and older patients views
- The impact of remote care approaches on continuity in primary care: a mixed-studies systematic review
- Optimising personal continuity: a survey of GPs and older patients views
- The impact of remote care approaches on continuity in primary care: a mixed-studies systematic review
- People with type 2 diabetes experiences of emotional support in Australian general practice: a qualitative study
- Building on sand: digital technologies for care coordination and advance care planning
- Chronic care services and variation between Danish general practices: a nationwide cohort study
- Continuity of care, measurement and association with hospital admission and mortality: a registry-based longitudinal cohort study
- Patient Health Outcomes following Dialysis Facility Closures in the United States
- The Importance of Primary Care Research in Understanding Health Inequities in the United States
- Developing measures to capture the true value of primary care
- When Physicians Say No: Predictors of Request Denial and Subsequent Patient Satisfaction
- Patients perceptions of continuity of care across primary care level and emergency departments in Belgium: cross-sectional survey
- How often do both core competencies of shared decision making occur in family medicine teaching clinics?
- Continuity of care in primary care and association with survival in older people: a 17-year prospective cohort study
- Early primary care physician contact and health service utilisation in a large sample of recently released ex-prisoners in Australia: prospective cohort study
- Effect of Continuity of Care on Hospital Utilization for Seniors With Multiple Medical Conditions in an Integrated Health Care System
- Older patients and their GPs: shared decision making in enhancing trust
- Patients assessments of the continuity of primary care in Finland: a 15-year follow-up questionnaire survey
- The Future Role of the Family Physician in the United States: A Rigorous Exercise in Definition
- The neglected repercussions of a physician advertising ban
- Does the "Office Nurse" Level of Training Matter in the Family Medicine Office?
- Correlates of a "do not hospitalize" designation: In a sample of frail nursing home residents in Vancouver
- Implications of Reassigning Patients for the Medical Home: A Case Study
- Why The Nation Needs A Policy Push On Patient-Centered Health Care
- Patients' perceptions of the quality of care after primary care reform: Family medicine groups in Quebec
- Receptor Sites for the Primary Care Function: Reaction to the Paper by Karen Davis, PhD, and Kristof Stremikis, MPP
- Learning and Caring in Communities of Practice: Using Relationships and Collective Learning to Improve Primary Care for Patients with Multimorbidity
- A Science of Connectedness
- The Paradox of Primary Care
- How should continuity of care in primary health care be assessed?
- Comprehending Care in a Medical Home: A Usual Source of Care and Patient Perceptions about Healthcare Communication
- The Medical Home: Growing Evidence to Support a New Approach to Primary Care
- Continuity of care matters
- Patients' Commitment to Their Primary Physician and Why It Matters
- Implementation of Advanced Access in general practice: postal survey of practices
- How are different types of continuity achieved? A mixed methods longitudinal study
- Patients' Perceptions of Interpersonal Continuity of Care
- GPs' attitudes to personal continuity: findings from everyday practice differ from postal surveys
- 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
- Liability Implications of Physician-Directed Care Coordination
- Continuity of Care and Patient Satisfaction in a Family Practice Clinic
- Physician-Patient Relationship and Medication Compliance: A Primary Care Investigation
- Provocative Questions
- In this Issue: Continuity of Care
- Continuity of Care: Process or Outcome?