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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.

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.

journal_name

Ann Fam Med

journal_title

Annals of family medicine

authors

Tousignant P,Diop M,Fournier M,Roy Y,Haggerty J,Hogg W,Beaulieu MD

doi

10.1370/afm.1692

subject

Has Abstract

pub_date

2014-11-01 00:00:00

pages

559-67

issue

eissn

1544-1709

issn

1544-1717

pii

12/6/559

journal_volume

pub_type

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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.