Longitudinal versus traditional residencies: a study of continuity of care.
OBJECTIVE
Continuity of care is one of the presumed advantages of longitudinal residencies. However, it is not clear how well such residencies provide continuity of care, and, further, there is no recognized acceptable rate of good continuity. We compared traditional and longitudinal residencies to determine the extent to which the residents provided their patients with continuity of care.


METHODS
We conducted a systematic chart review at three longitudinal and three matched traditional block-rotation programs. In total, 628 charts were reviewed, and 6,256 visits were evaluated. Continuity with a primary resident was evaluated over a 2-year period, with continuity defined as the percentage of visits for which the patient saw the same resident.


RESULTS
There was no significant difference in overall rates of continuity between longitudinal and traditional programs (59.6% versus 57.8%). One longitudinal program, however, had a 74.8% rate of continuity, which was significantly higher than the rates in the otherfive programs.


CONCLUSIONS
There was no significant difference found in continuity of care provided by residents at longitudinal programs, compared with those at traditional programs. Our results do not support the hypothesis that longitudinal residency programs achieve superior rates of continuity of care. Further comparison studies of longitudinal and traditional programs would be useful.
Merenstein
D
D
Fairfax Family Practice Residency, Arlington, VA, USA. dmerenstein@yahoo.com
Damico
F
F
Devine
B
B
Mahaniah
K J
KJ
Solomon
M
M
Reust
C E
CE
Rosenbaum
D J
DJ
D000704:Analysis of Variance; D002983:Clinical Competence; D016001:Confidence Intervals; D003266:Continuity of Patient Care / Q000706:statistics & numerical data*; D003625:Data Collection; D004521:Educational Measurement; D005194:Family Practice / Q000193:education*; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000379:methods / Q000458:organization & administration / Q000706:statistics & numerical data*; D008137:Longitudinal Studies; D008297:Male; D016730:Program Development; D015397:Program Evaluation; D014481:United States