Related Experiment Video
Updated: Nov 30, 2025
Methodology for Establishing a Community-Wide Life Laboratory for Capturing Unobtrusive and Continuous Remote Activity and Health Data
Published on: July 27, 2018
Association between continuity and access in primary care: a retrospective cohort study
Lisa L Cook1, Richard P Golonka2, Charles M Cook2
1Applied Research & Evaluation Services, Primary Health Care (L. Cook, C. Cook), Alberta Health Services; Faculty of Health Sciences (L. Cook, Spenceley), University of Lethbridge, Lethbridge, Alta.; Applied Research & Evaluation Services, Primary Health Care (Golonka), Alberta Health Services, Edmonton, Alta.; Applied Research & Evaluation Services, Primary Health Care (Walker), Alberta Health Services; Cumming School of Medicine (Walker, Faris), University of Calgary; Health Services Statistical & Analytics Methods, Analytics, Data Integration, Measurement & Reporting (Faris), Alberta Health Services, Calgary, Alta.; Enhancing Care in the Community (Lewanczuk), Alberta Health Services; Department of Medicine (Lewanczuk), University of Alberta, Edmonton, Alta.; Chinook Primary Care Network (Wedel, Byers, Collins); Primary Health Care Integration Network (Love), Alberta Health Services; Public & Primary Health Care (Andres), Alberta Health Services, Lethbridge, Alta.; Applied Research & Evaluation Services, Primary Health Care (Oddie), Alberta Health Services, Red Deer, Alta.; Faculty of Social Sciences (Oddie), University of Calgary, Calgary, Alta. Lisa.Cook@ahs.ca.
Improving primary care physician access enhances patient continuity of care. Better access reduces emergency department visits and improves provider continuity, while worsening access has the opposite effect.
Area of Science:
- Primary Care Medicine
- Health Services Research
- Health Policy
Background:
- Continuity of care is a fundamental principle of primary care.
- Understanding factors influencing continuity is crucial for effective healthcare delivery.
Purpose of the Study:
- To investigate the relationship between changes in primary care physician (PCP) access and continuity of care.
- To assess the impact of improved and worsened PCP access on provider continuity, discontinuity, and emergency department (ED) utilization.
Main Methods:
- Retrospective cohort study of 190 primary care physicians in Alberta, Canada (2009-2016).
- Access measured by time to the third next available appointment.
- Provider continuity, clinic continuity, discontinuity, and ED visits analyzed using multilevel models.
Main Results:
- Physicians with improved access showed a 6.8% annual increase in provider continuity and a 2.1% annual reduction in discontinuity.
- Improved access was associated with 78 fewer ED visits per 1000 patients annually compared to stable access.
- Worsening access correlated with a 6.2% decrease in provider continuity and 64 more ED visits per 1000 patients annually.
Conclusions:
- Changes in PCP appointment access significantly impact patient continuity of care.
- Improving access, by reducing wait times for appointments, may be a key strategy to enhance continuity and reduce ED use.
- Healthcare systems should focus on optimizing PCP access to strengthen primary care delivery.
More Related Videos
Related Concept Videos
01:11Observational Studies
There are three types of observational studies – Prospective, retrospective, and cross-sectional.
Prospective Study
Prospective studies, also known as longitudinal or cohort studies, are carried out by collecting future data from groups sharing similar characteristics. One...
01:26Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
01:30Primary Healthcare Services
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...
01:29Nursing Assessment
The nurse collects all aspects of the patient's health in the initial assessment, establishing priorities for ongoing focused assessments...
01:29Documentation in Long-Term and Home Healthcare Setting
Long-Term Care Facilities
01:08Data Collection by Observations
An astronomer viewing the motion and brightness of stars in the sky and recording the data is an example of observational data collection. A botanist recording...