What factors are associated with achieving high continuity of care?
OBJECTIVE
Although continuity of care has been found to be associated with improved health outcomes in children, little is known about what factors predict having consistent contact with a pediatric provider. This study explored what patient, family, provider, and system factors are associated with high continuity of both total and well-child care.


METHODS
This cross-sectional study involved 759 patients presenting to a primary care pediatric clinic. Patients completed surveys about demographic variables, attitudes about continuity of care, and family functioning, as well as provider-level information. Outcomes were measured with a continuity of care index that quantified the degree to which a patient experienced continuous care with a provider.


RESULTS
In Tobit regression models, the variables associated with increased total continuity of care were continuity belief, higher family control, increased provider availability, and better provider rating. Associated with decreased total continuity of care were: number of visits, patient age, and time at clinic. For well-child care, the variables associated with increased continuity of care were continuity belief, increased provider availability, better provider rating, and greater reported household income. Provider availability was the strongest predictor of total continuity of care, and continuity belief was the strongest predictor of well-child continuity of care.


CONCLUSIONS
Increased provider availability may improve overall continuity of care for pediatric patients.
Christakis
Dimitri A
DA
Department of Pediatrics, University of Washington, Seattle, WA 98115-8160, USA. dachris@u.washington.edu
Kazak
Anne E
AE
Wright
Jeffrey A
JA
Zimmerman
Frederick J
FJ
Bassett
Alta L
AL
Connell
Frederick A
FA
D001294:Attitude to Health; D002648:Child; D002675:Child, Preschool; D003266:Continuity of Patient Care / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005190:Family; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D016014:Linear Models; D008297:Male; D010372:Pediatrics / Q000592:standards*; D011320:Primary Health Care / Q000592:standards*; D012307:Risk Factors; D011795:Surveys and Questionnaires