PT  - JOURNAL ARTICLE
AU  - Wright, Katherine
AU  - Panzer, Jeff
AU  - Simon, Jodi
AU  - Ekong, Abbey
TI  - Continuity and Relationships Among Patients, Physicians, and Care Teams (CARE PACT)
AID  - 10.1370/afm.22.s1.6078
DP  - 2024 Nov 20
TA  - The Annals of Family Medicine
PG  - 6078
VI  - 22
IP  - Supplement 1
4099  - http://www.annfammed.org/content/22/Supplement_1/6078.short
4100  - http://www.annfammed.org/content/22/Supplement_1/6078.full
SO  - Ann Fam Med2024 Nov 20; 22
AB  - Context: A patient’s relationship with their primary care physician (PCP) or advanced practice provider (APP) is instrumental in their healthcare journey. Examining continuity and relationships in a new way— focusing on both PCP continuity from the physician/APP perspective, and looking at care team size from the patient perspective—will shine a new light on challenges in achieving continuity several years into the patient-centered medical home (PCMH) movement. Continuity is particularly critical in the resource constrained setting of federally qualified health centers (FQHCs) that treat populations with complex medical and behavioral health needs.Objective: 1) evaluate the number of providers involved in a patient’s care over time; 2) evaluate PCP continuity with patients in their own panel and patient continuity with their designated primary care provider; and 3) explore factors correlated with continuity measures.Study Design and Analysis: We conducted a secondary data analysis of EHR data which include n=10,279,755 encounters among n=278,406 unique patients. We also collected organizational characteristics from 19 FQHCs via survey.Dataset: EHR data include: PCP/APP characteristics (specialty, location), patient demographics (age, ethnicity, responsible provider), and encounter data (type, date, provider). Organizational characteristics include size, PCMH certification, and presence of central scheduling.Population Studied: Patients and PCPs/APPs within a national network of FQHCs over a 15-year period.Outcome Measures: Patient-level continuity metrics include the Usual Provider of Care Index (UPC), defined as the number of visits a patient has with their most frequent provider divided by their total number of visits. We also calculated the number of PCPs/APPs seen over 1- and 5-year intervals. The provider-level continuity index was calculated by dividing the number of in-panel visits by the total number of visits over the last year.Results: 43% of designated providers were from non-primary care specialties. Over the last year, the aggregate provider continuity index was 0.53 and the aggregate patient UPC was 0.74. When expanding the analysis to a 5-year interval, the aggregate patient UPC dropped to 0.47. Full results to be presented at the meeting.Conclusions: While continuity was relatively strong in the short term, it was less robust over the long term. Short term continuity measures may be inadequate in a longitudinal field like primary care