title: Continuity of care is associated with high-quality careby parental report.
abstract: 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.
authors.affiliation: Department of Pediatrics, Child Health Institute, University of Washington, Seattle, Washington 98103-8652, USA. dachris@u.washington.edu
authors.forename: Dimitri A
authors.initials: DA
authors.lastname: Christakis
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Wright
authors.forename: Frederick J
authors.initials: FJ
authors.lastname: Zimmerman
authors.forename: Alta L
authors.initials: AL
authors.lastname: Bassett
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Connell
mesh_terms: 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