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Does a residents' continuity clinic provide primary care?
M E Wilson1, J P Weiner, J C Bender
1Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Md.
Insights
Hospital outpatient clinics can offer valuable primary care experiences for pediatric residents. The Johns Hopkins Primary Care Clinic demonstrated superior principal care provision compared to private practices and walk-in clinics.
Area of Science:
- Medical Education
- Primary Care Pediatrics
- Healthcare Quality
Background:
- Pediatric residency programs require continuity experiences for trainees.
- Continuity clinics, often hospital-based outpatient departments, may vary in their primary care delivery.
- Assessing the primary care capacity of these training sites is crucial.
Purpose of the Study:
- To evaluate the primary care services provided by The Johns Hopkins Hospital's Primary Care Clinic.
- To compare the clinic's primary care performance against local private pediatric practices and a walk-in clinic.
Main Methods:
- A primary care measure was applied to assess the "principal care" component of encounters.
- Data were collected from The Johns Hopkins Primary Care Clinic, private pediatric practices, and a walk-in clinic.
- A primary care index was used to quantify the facility's role as a patient's primary care source.
Main Results:
- The Johns Hopkins Primary Care Clinic provided "principal care" in 93% of encounters, exceeding private practices (84.5%) and a walk-in clinic (51%).
- The clinic achieved a higher score on the primary care index, indicating a stronger role as a primary care source.
- These findings suggest hospital-based clinics can effectively facilitate primary care training.
Conclusions:
- Hospital-based continuity clinics can successfully provide comprehensive primary care for pediatric patients.
- This model offers pediatric residents robust training opportunities in primary care delivery.
- Continuity clinics are vital for ensuring residents develop essential primary care competencies.
Abstract:
Pediatric residents are required to care for a group of children over a period of time. For many, this "continuity" experience is in a hospital outpatient department that may or may not provide primary care. We applied a measure of primary care to the Primary Care Clinic, the continuity clinic at The Johns Hopkins Hospital, Baltimore, Md, and found that it compared favorably with private pediatric practices in the Baltimore area, providing significantly more "principal care" (93% vs. 84.5% of encounters), and to the Harris Lane Home walk-in clinic, where only 51% of encounters were "principal care". The Primary Care Clinic scored higher on a primary care index, a measure of the extent to which the facility serves as a primary care source for patients, suggesting that hospital-based training can provide residents with an opportunity to provide primary care.