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Continuity of care is associated with well-coordinated care
Dimitri A Christakis1, Jeffrey A Wright, Frederick J Zimmerman
1Department of Pediatrics, University of Washington, Seattle 98115, USA. dachris@u.washington.edu
Context:
The importance of continuity of care as a means to promote care coordination remains controversial.
Objective:
To determine if there is an association between having an objective measure of continuity of care and parental perception that care is well coordinated.
Design:
Cross-sectional study.
Setting And Population:
Seven hundred fifty-nine patients presenting to a primary care clinic completed surveys that included 5 items from the Components of Primary Care Index (CPCI) that relate to care coordination. MAIN PREDICTOR VARIABLE: A continuity of care index (COC) that quantifies the degree of dispersion of care among providers.
Main Outcome Measures:
Likelihood of parents reporting high scores on the care coordination domain as well as each of the 5 individual CPCI items related to care coordination.
Results:
Greater continuity of care was associated with higher scores on the CPCI care-coordination domain (P <.001). Continuity of care was also specifically associated with increased odds of agreeing with all 5 individual CPCI items, including reporting that their child's provider "always knows about care my child received in other places" (OR 3.97 [2.11-7.49]), "communicates with the other health care providers my child sees" (OR 2.98 [1.63-5.44]), "knows the results of my child's visits to other doctors" (OR 2.02 [1.08-3.80]), and "always follows up on a problem my child has had, either at the next visit or by phone" (OR 6.20 [2.88-13.35]) and wanting one provider to coordinate all of the health care that the child receives (OR 3.28 [1.48-7.27]).
Conclusions:
Greater continuity of primary care is associated with better care coordination as perceived by parents. Efforts to improve and maintain continuity may be justified.