Continuity of care in a university-based practice

Area of Science:

• Pediatric Healthcare
• Health Services Research
• Continuity of Care

Background:

• Changes in pediatric practice settings, including expansion and university affiliation, can influence care delivery.
• Continuity of care is a critical component of effective pediatric healthcare.

Purpose of the Study:

• To examine the effects of practice expansion and university incorporation on continuity of care and healthcare utilization in a pediatric setting.
• To analyze the relationship between changes in practice structure and the continuity of well-child and sick visits.

Main Methods:

• A longitudinal study was conducted with a sample of 63 families.
• Continuity of care was measured using an index: (visits with own physician) / (total pediatric visits per year).

Main Results:

• Continuity of well-child visits remained stable after the practice moved to a university setting.
• Continuity of sick visits significantly declined in the new university hospital environment.
• An increase in the utilization of doctor visits for illness care was observed.

Conclusions:

• Continuity of care is more inherent in small practice settings than in larger, university-affiliated organizations.
• The part-time involvement of physicians in larger organizations can negatively impact continuity.
• Deliberate strategies are necessary to ensure patients can access their regular doctors for acute care needs within large medical systems.