Personal doctoring. Its impact on continuity of care as measured by the comprehensiveness of care score.
OBJECTIVE
To determine the impact of personal provider continuity on continuity of care as measured by the comprehensiveness of care score.


METHODS
Retrospective cross sectional analysis of medical records.


METHODS
The setting was a four doctor practice on the New South Wales Central Coast of Australia.


METHODS
The subjects were 131 male and 123 female patients with a mean age of 42.7 years (SD 25.9) median age of 42 years and an age range of 1-95 years. The main outcome measures were a comprehensiveness score for each patient in the personal provider continuity and discontinuity of care group over a two year period.


RESULTS
The overall comprehensiveness scores in the personal provider continuity group was 7.38 (95% CI: 7.04-7.71) compared to 6.03 (95% CI: 5.7-6.35) for those in the discontinuity group (p < 0.000). A linear regression model revealed that 15.8% of the total variance of the comprehensiveness score is explained by the two independent variables 'modified continuity index' (13.6%) and 'age' (2.2%). Nonrelated independent variables are gender, number of visits and number of years attending the practice.


CONCLUSIONS
Personal doctoring significantly improves continuity of care as measured by the comprehensiveness of care score, and this observation is essentially age independent. These findings clearly suggest that patients should be encouraged to find and stay with one doctor, and that practices should develop systems to enable patients access to their usual provider. Both strategies, combined with the awareness of potential gaps in our service provision, will increase the likelihood of achieving increased continuity of care.
Sturmberg
J P
JP
Greater Murray Clinical School, University of NSW. j.sturmberg@unsw.edu.au
Schattner
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia; D002648:Child; D002675:Child, Preschool; D003191:Comprehensive Health Care / Q000145:classification / Q000592:standards*; D003266:Continuity of Patient Care / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005194:Family Practice / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010817:Physician-Patient Relations; D012189:Retrospective Studies; D012680:Sensitivity and Specificity