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Research ArticleOriginal Research

Validation of 2 New Measures of Continuity of Care Based on Year-to-Year Follow-up With Known Providers of Health Care

Pierre Tousignant, Mamadou Diop, Michel Fournier, Yves Roy, Jeannie Haggerty, William Hogg and Marie-Dominique Beaulieu
The Annals of Family Medicine November 2014, 12 (6) 559-567; DOI: https://doi.org/10.1370/afm.1692
Pierre Tousignant
1Population Health and Health Services Team of the Montreal Health and Social Services Agency, Public Health Department, and the Quebec National Public Health Institute, Department of Health Systems Analysis and Evaluation, Montreal, Quebec
3The Department of Epidemiology, Biostatistics and Occupational Health, McGill University Montreal, Quebec
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  • For correspondence: ptousi@santepub-mtl.qc.ca
Mamadou Diop
1Population Health and Health Services Team of the Montreal Health and Social Services Agency, Public Health Department, and the Quebec National Public Health Institute, Department of Health Systems Analysis and Evaluation, Montreal, Quebec
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Michel Fournier
2Montreal Health and Social Services Agency, Public Health Department
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Yves Roy
1Population Health and Health Services Team of the Montreal Health and Social Services Agency, Public Health Department, and the Quebec National Public Health Institute, Department of Health Systems Analysis and Evaluation, Montreal, Quebec
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Jeannie Haggerty
4Department of Family Medicine, McGill University, Montreal, Quebec
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William Hogg
5Department of Family Medicine, University of Ottawa, Ottawa, Ontario
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Marie-Dominique Beaulieu
6Department of Family Medicine and Emergency Medicine, University of Montreal, Montreal, Quebec
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Abstract

PURPOSE In a primary care context favoring group practices, we assessed the validity of 2 new continuity measures (both versions of known provider continuity, KPC) that capture the concentration of care over time from multiple physicians (multiple provider continuity, KPC-MP) or from the physician seen most often (personal provider continuity, KPC-PP).

METHODS Patients with diabetes or cardiovascular disease (N = 765) were approached in the waiting rooms of 28 primary care clinics in 3 regions of the province of Quebec, Canada; answered a survey questionnaire measuring relational continuity, interpersonal communication, coordination within the clinic, coordination with specialists, and overall coordination; and gave permission for their medical records to be reviewed and their medical services utilization data for the previous 2 years to be accessed to measure KPC. Using generalized linear mixed models, we assessed the association between KPC and the patients’ responses.

RESULTS Among the 5 different patient-reported measures or their combination, KPC-MP was significantly related with overall coordination of care: for high continuity, the odds ratio (OR) = 2.02 (95% CI, 1.33–3.07), and for moderate continuity, OR = 1.61 (95% CI, 1.06–2.46). KPC-MP was also related with the combined continuity score: for high continuity, OR = 1.52 (95% CI, 1.11–2.09), and for moderate continuity, OR = 1.48 (95% CI, 1.10–2.00). KPC-PP was not significantly associated with any of the survey measures.

CONCLUSIONS The KPC-MP measure, based on readily available administrative data, is associated with patient-perceived overall coordination of care among multiple physicians. KPC measures are potentially a valuable and low-cost way to follow the effects of changes favoring group practice on continuity of care for entire populations. They are easy to replicate over time and across jurisdictions.

  • continuity of patient care
  • group practice
  • primary health care
  • patient care team
  • Received for publication September 3, 2013.
  • Revision received February 28, 2014.
  • Accepted for publication July 1, 2014.
  • © 2014 Annals of Family Medicine, Inc.
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The Annals of Family Medicine: 12 (6)
The Annals of Family Medicine: 12 (6)
Vol. 12, Issue 6
November/December 2014
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Validation of 2 New Measures of Continuity of Care Based on Year-to-Year Follow-up With Known Providers of Health Care
Pierre Tousignant, Mamadou Diop, Michel Fournier, Yves Roy, Jeannie Haggerty, William Hogg, Marie-Dominique Beaulieu
The Annals of Family Medicine Nov 2014, 12 (6) 559-567; DOI: 10.1370/afm.1692

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Validation of 2 New Measures of Continuity of Care Based on Year-to-Year Follow-up With Known Providers of Health Care
Pierre Tousignant, Mamadou Diop, Michel Fournier, Yves Roy, Jeannie Haggerty, William Hogg, Marie-Dominique Beaulieu
The Annals of Family Medicine Nov 2014, 12 (6) 559-567; DOI: 10.1370/afm.1692
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