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papers

Validation of 2 new measures of continuity of care based on year-to-year follow-up with known providers of health care

Published: November 1, 2014
Category: Papers
Authors: Beaulieu MD, Diop M, Fournier M, Haggerty J, Hogg W, Roy Y, Tousignant P
Country: Canada
Language: null
Type: Care Management
Settings: Health Plan, Hospital

Ann Fam Med 12:559-567.

Montreal Health and Social Services Agency, Montreal, QC, Canada

PURPOSE: In a primary care context favoring group practices, we assessed the validity of 2 new continuity measures (both versions of known provider continuity, KPC) that capture the concentration of care over time from multiple physicians (multiple provider continuity, KPC-MP) or from the physician seen most often (personal provider continuity, KPC-PP).

METHODS: Patients with diabetes or cardiovascular disease (N = 765) were approached in the waiting rooms of 28 primary care clinics in 3 regions of the province of Quebec, Canada; answered a survey questionnaire measuring relational continuity, interpersonal communication, coordination within the clinic, coordination with specialists, and overall coordination; and gave permission for their medical records to be reviewed and their medical services utilization data for the previous 2 years to be accessed to measure KPC. Using generalized linear mixed models, we assessed the association between KPC and the patients’ responses.

RESULTS: Among the 5 different patient-reported measures or their combination, KPC-MP was significantly related with overall coordination of care: for high continuity, the odds ratio (OR) = 2.02 (95% CI, 1.33-3.07), and for moderate continuity, OR = 1.61 (95% CI, 1.06-2.46). KPC-MP was also related with the combined continuity score: for high continuity, OR = 1.52 (95% CI, 1.11-2.09), and for moderate continuity, OR = 1.48 (95% CI, 1.10-2.00). KPC-PP was not significantly associated with any of the survey measures.

CONCLUSIONS: The KPC-MP measure, based on readily available administrative data, is associated with patient-perceived overall coordination of care among multiple physicians. KPC measures are potentially a valuable and low-cost way to follow the effects of changes favoring group practice on continuity of care for entire populations. They are easy to replicate over time and across jurisdictions.

PMID: 25384820
PMCID: PMC4226779

Canada,Cost Burden Evaluation,Outcome Measures,Practice Pattern Comparison,Care Management,Adult,Aged,Cardiovascular Diseases/therapy,Communication,Critical Pathways,Diabetes Mellitus/therapy,Gender,Linear Models,Middle Aged,Office Visits/statistics & numerical data,Patient Care Team,Physician-Patient Relations,Primary Health Care/organization & administration,Quebec,Referral and Consultation,Surveys and Questionnaires,Time Factors,Young Adult

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