Entry into primary care and continuity: the effects of access

Area of Science:

• Health Services Research
• Primary Care Medicine
• Healthcare Access

Background:

• Continuity with the medical system is essential for effective healthcare delivery.
• Primary care physicians serve as key entry points for medical care.
• Understanding factors influencing primary care utilization is vital for health policy.

Purpose of the Study:

• To investigate the association between healthcare access and the utilization of primary care physicians.
• To determine how access influences both first contact and continuity of care.
• To identify specific barriers to accessing primary care.

Main Methods:

• Utilized data from the 1987 National Medical Expenditure Survey.
• Employed logistic regression to analyze first contact with primary care physicians.
• Used multivariate linear regression to assess continuity of care for ambulatory visits.

Main Results:

• Limited after-hours care, extended office waits, and longer travel times decreased first-contact visits for acute issues.
• Longer appointment waits, lack of insurance, and no after-hours care were linked to reduced continuity.
• General practitioners offered more first-contact care due to practice accessibility compared to specialists.

Conclusions:

• Demonstrated a significant relationship between healthcare access and seeking care from primary care physicians.
• Findings support the importance of accessible primary care for patient engagement.
• Accessibility of primary care practices influences care-seeking behaviors.