Continuity of Primary Care in Community Health Centers

Area of Science:

• Health Services Research
• Primary Care Medicine
• Public Health

Background:

• Community Health Centers (CHCs) are vital for primary care access.
• Assessing primary care continuity is crucial for evaluating healthcare quality.
• The COVID-19 pandemic significantly impacted healthcare delivery models.

Purpose of the Study:

• To evaluate changes in primary care continuity within CHCs from 2019-2023.
• To identify patient and visit characteristics associated with primary care continuity in CHCs.

Main Methods:

• Cross-sectional cohort study using national CHC data (2019-2023).
• Calculated Usual Provider of Care (UPC) index for patients with ≥2 primary care visits annually.
• Employed age-stratified multilevel logistic regression to analyze factors associated with perfect UPC (index of 1) in 2023.

Main Results:

• Median UPC index remained high (1) annually; mean index ranged from 0.822 (2020) to 0.831 (2021).
• In 2023, adults with higher income and older age were more likely to have perfect continuity.
• Hispanic ethnicity, Black race, multimorbidity, telehealth visits, and large clinic size were associated with lower continuity in adults and children.

Conclusions:

• Primary care continuity in CHCs remained robust before, during, and after the COVID-19 pandemic.
• Patient and practice characteristics identified can guide interventions to enhance continuity.
• CHCs continue to prioritize and provide high-continuity primary care.