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Related Experiment Videos

Primary care practice coordination versus physician continuity.

Patricia H Parkerton1, Dean G Smith, Hugh L Straley

  • 1Department of Health Services, UCLA School of Public Health, Los Angeles, CA 90095-1772, USA. parkert@ucla.edu

Family Medicine
|January 8, 2004
PubMed
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Primary care practice structure, not physician continuity, impacts patient outcomes. Enhanced practice coordination, including shared practice and clinic size, improves cancer screening, diabetes management, and patient satisfaction.

Area of Science:

  • Health Services Research
  • Primary Care Medicine
  • Quality Improvement

Background:

  • Primary care continuity, encompassing both clinician and system aspects, is presumed to benefit patient outcomes.
  • This study examines physician continuity and practice coordination within a multi-specialty group setting.

Purpose of the Study:

  • To assess the influence of primary care continuity (clinician and system) on patient outcomes.
  • To evaluate the impact of physician continuity and practice coordination in a multi-specialty group.

Main Methods:

  • Evaluated practices of 194 family physicians and general internists serving 320,000 health maintenance organization members.
  • Utilized aggregate outcome measures: cancer screening, diabetic management, patient satisfaction, and ambulatory costs.

Related Experiment Videos

  • Employed sequential multiple regression models to assess physician continuity and practice coordination, controlling for patient and physician characteristics.

    • Main Results:

    • Physician continuity (seeing the same doctor annually) showed no association with patient outcomes.
    • Practice coordination (shared practice, team tenure, clinic size) significantly correlated with three outcomes.
    • Larger medical clinic size and shared practice linked to higher cancer screening and diabetic management rates.
    • Team tenure positively associated with cancer screening, diabetic management, and patient satisfaction.

    Conclusions:

    • Primary care practice structure, specifically practice coordination, influences patient outcomes, not physician continuity alone.
    • Further assessment of practice coordination is needed to identify mechanisms for improving patient care.