title: Is family care associated with reduced health care expenditures?
abstract: BACKGROUND
  Specific components of family medicine associated with reduced health care costs are not well understood. We examined whether people who received "family care," the sharing of a personal physician across familial generations, had lower health care expenditures than those who received "individual care" that lacked generational continuity.
  
  
  METHODS
  We studied 1728 children and 2543 adults using a data subset of the 1987 National Medical Expenditure Survey, a representative sample of the civilian noninstitutionalized US population, to examine the relationship between care category and total health care expenditures, adjusting for potential confounders and effect modifiers. Survey respondents from households with either a married or a single woman aged 18 to 55 years as head of household and at least 1 child younger than 18 years were included. Only individuals reporting a family physician (FP) or general practitioner (GP) as their personal doctor were examined, since intergenerational family care is provided almost exclusively by FPs and GPs.
  
  
  RESULTS
  Family care provided by an FP or GP was associated with 14% lower expenditures for adults ($51), after adjustment for covariates (P = .04), compared with individual care provided by a family or general practitioner. Although not statistically significant, for children family care was associated with 9% lower expenditures ($19).
  
  
  CONCLUSIONS
  These findings suggest that family care provided by FPs or GPs is associated with lower health care costs. Policies promoting family care may reduce health care costs.
authors.affiliation: Department of Family Medicine, University of Washington, Seattle 98105-6099, USA. mdoesche@u.washington.edu
authors.forename: M P
authors.initials: MP
authors.lastname: Doescher
authors.forename: P
authors.initials: P
authors.lastname: Franks
authors.forename: B G
authors.initials: BG
authors.lastname: Saver
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003430:Cross-Sectional Studies; D005190:Family; D005194:Family Practice / Q000191:economics*; D005260:Female; D017048:Health Care Costs; D005102:Health Expenditures; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D014481:United States