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When is caring sharing? Primary care provider interdependence and continuity of care
Christine M Everett1, Jacob Christy, Perri A Morgan
1Christine M. Everett is program director and division chief of the PA program at the Medical College of Wisconsin in Milwaukee. Jacob Christy is digital project manager at Medable, Inc., in Palo Alto, Calif. Perri A. Morgan is a professor in the PA program at Duke University in Durham, N.C. Sharron L. Docherty is an associate professor in the School of Nursing at Duke University. Valerie A. Smith is an associate professor in population health sciences and medicine at Duke University and at the Durham Veterans Affairs Health Care System's Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT) in Durham, N.C. John B. Anderson, Jr ., practices at Duke Primary Care in Durham, N.C. Anthony Viera practices in the Department of Family Medicine and Community Health at Duke University School of Medicine. George L. Jackson is a professor in population health sciences and medicine at ADAPT. This research was supported by a grant from the National Institutes of Aging. The grant funding source had no role in the design, conduct, collection, management, analysis, or interpretation of the data; or in the preparation, review, or approval of the manuscript. The authors have disclosed no potential conflicts of interest, financial or otherwise.
Abstract:
Efforts to improve access to high-quality, efficient primary care have highlighted the need for team-based care. Most primary care teams are designed to maintain continuity of care between patients and primary care providers (PCPs), because continuity of care can improve some patient outcomes. However, PCPs are interdependent because they care for, or share, patients. PCP interdependence, and its association with continuity of care, is not well described. This study describes a measure of PCP interdependence. We also evaluate the association between patient and panel characteristics, including PCP interdependence. Our results found that the extent of interdependence between PCPs in the same clinic varies widely. A range of patient and panel characteristics affect continuity of care, including patient complexity and PCP interdependence. These results suggest that continuity of care for complex patients is sensitive to panel characteristics, including PCP interdependence and panel size. This information can be used by primary care organizations for evidence-based team design.
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