Continuity of care is associated with high-quality careby parental report.
BACKGROUND
The benefits of continuity of pediatric care remain controversial.


OBJECTIVE
To determine whether there is an association between having a continuous relationship with a primary care pediatric provider and improved quality of care by parental report.


METHODS
Cross-sectional study.


METHODS
Seven hundred fifty-nine patients presenting to a primary care clinic completed surveys, which included validated measures of provider and clinic quality of care from the Consumer Assessment of Health Plan Survey. MAIN EXPOSURE VARIABLE: A continuity of care index that quantifies the degree to which a patient has experienced continuous care with a provider.


METHODS
The likelihood of parents reporting quality of care as high in several provider- specific items including reporting that providers respected what they had to say, treated them with courtesy and respect, listened to them carefully, explained things in a way they could understand, and spent enough time with their children. In addition, participants were asked to rate the overall quality of the clinic and their child's provider on a 10-point scale.


RESULTS
In ordered logistic regression models, continuity of care was associated with statistically significantly higher Consumer Assessment of Health Plan Survey scores for 5 of the 6 items, including feeling that providers respected what parents had to say; listened carefully to them; explained things in a way that they could understand; asked about how their child was feeling, growing, and behaving; and spent enough time with their child. In addition, greater continuity of care was associated with a higher clinic rating, as well as a higher provider rating.


CONCLUSIONS
Greater continuity of primary care is associated with higher quality of care as reported by parents. Efforts to improve and maintain continuity may be warranted.
Christakis
Dimitri A
DA
Department of Pediatrics, Child Health Institute, University of Washington, Seattle, Washington 98103-8652, USA. dachris@u.washington.edu
Wright
Jeffrey A
JA
Zimmerman
Frederick J
FJ
Bassett
Alta L
AL
Connell
Frederick A
FA
D002662:Child Health Services / Q000592:standards* / Q000706:statistics & numerical data; D002675:Child, Preschool; D003266:Continuity of Patient Care / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D006306:Health Surveys; D006801:Humans; D010290:Parents; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D010372:Pediatrics / Q000592:standards / Q000706:statistics & numerical data; D010817:Physician-Patient Relations; D015397:Program Evaluation; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D014861:Washington