Evaluating continuity of care in primary care internal medicine programs

Area of Science:

• Medical Education
• Primary Care Training
• Health Services Research

Background:

• Primary care training programs aim to foster "continuity experiences" for residents.
• Federally funded programs are mandated to provide and evaluate continuity of care.
• Variability exists in defining and assessing continuity within these programs.

Purpose of the Study:

• To investigate and evaluate the methods used by federally funded primary care internal medicine programs to assess resident continuity experiences.
• To understand the prevalence and types of continuity assessment tools employed.

Main Methods:

• A survey was conducted using a checklist of methods derived from existing literature.
• Fifty-two federally funded primary care internal medicine residency programs were targeted.
• Response rate was 64%, with 50 programs reporting on their continuity evaluation practices.

Main Results:

• Nearly all responding programs (96%) reported evaluating continuity of care.
• Most programs utilized multiple methods for assessment.
• Tracking resident follow-up of admitted patients was more common than assessing ambulatory care continuity.
• Ambulatory continuity assessment, such as patient visit frequency, ranked lower than methods like medical record audits and tracking missed appointments.

Conclusions:

• Primary care residency programs widely assess continuity, but methods vary significantly.
• There is a greater emphasis on evaluating inpatient continuity compared to ambulatory continuity.
• Further standardization and focus on ambulatory continuity assessment may be needed in primary care training.