Preventive care.
OBJECTIVE
To examine the impact of provider continuity on preventive care among adults who have a regular site of care.


METHODS
Logistic regression analyses were conducted to explore whether continuity, categorized as having no regular care, site continuity, or provider continuity, was associated with receipt of 3 preventive care services (influenza vaccination, receipt of a mammogram, and smoking cessation advice), independent of predisposing, need, and enabling factors.


METHODS
This study examined 42664 persons with private, Medicaid, Medicare, or no health insurance coverage who reported either having no site of care or being seen in a physician's office, HMO, hospital outpatient department, or other health center.


METHODS
The 1996/1997 Community Tracking Study (CTS) household survey, a telephone-based survey providing a cross-sectional sample of 60446 U.S. adults aged 18 and older representing the U.S. housed, noninstitutionalized population.


RESULTS
After adjustment for differences in predisposing, enabling, and need factors, site continuity was associated with significant increases of 10.4% in influenza vaccinations (P =.006) and 12.6% in mammography (P =.001), and a nonsignificant increase of 5.6% in smoking cessation advice (P =.13) compared to having no regular site of care. After adjustment for these factors, provider continuity was associated with an additional improvement of 6.0% in influenza vaccinations (P =.01) and 6.2% in mammography (P =.04), and a nonsignificant increase of 2.5% in smoking cessation advice (P =.30) compared to site continuity.


CONCLUSIONS
Provider continuity and site continuity are independently associated with receipt of preventive services. Compared to having no regular site of care, having site continuity was associated with increased receipt of influenza vaccination and mammography and, compared to having site continuity, having provider continuity was associated with further increases in the receipt of these two preventive services.
Doescher
Mark P
MP
Department of Family Medicine, University of Washington School of Medicine, Seattle, Washington 98195-4696, USA. mdoesche@u.washington.edu
Saver
Barry G
BG
Fiscella
Kevin
K
Franks
Peter
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D003266:Continuity of Patient Care / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008327:Mammography / Q000706:statistics & numerical data; D008875:Middle Aged; D011314:Preventive Health Services / Q000592:standards* / Q000706:statistics & numerical data; D011315:Preventive Medicine / Q000592:standards*; D016540:Smoking Cessation / Q000706:statistics & numerical data; D014481:United States; D014611:Vaccination / Q000706:statistics & numerical data