Portal de Periódicos da CAPES

Continuity of Care Is Associated With Well-Coordinated Care

2003; Elsevier BV; Volume: 3; Issue: 2 Linguagem: Inglês

10.1367/1539-4409(2003)003 2.0.co;2

1539-4409

Dimitri Christakis, Jeffrey A. Wright, Frederick J. Zimmerman, Alta L. Bassett, Frederick A. Connell,

Chronic Disease Management Strategies

Context.—The importance of continuity of care as a means to promote care coordination remains controversial. Objective.—To determine if there is an association between having an objective measure of continuity of care and parental perception that care is well coordinated. Design.—Cross-sectional study. Setting and Population.—Seven hundred fifty-nine patients presenting to a primary care clinic completed surveys that included 5 items from the Components of Primary Care Index (CPCI) that relate to care coordination. Main Predictor Variable.—A continuity of care index (COC) that quantifies the degree of dispersion of care among providers. Main Outcome Measures.—Likelihood of parents reporting high scores on the care coordination domain as well as each of the 5 individual CPCI items related to care coordination. Results.—Greater continuity of care was associated with higher scores on the CPCI care-coordination domain (P < .001). Continuity of care was also specifically associated with increased odds of agreeing with all 5 individual CPCI items, including reporting that their child's provider “always knows about care my child received in other places” (OR 3.97 [2.11–7.49]), “communicates with the other health care providers my child sees” (OR 2.98 [1.63–5.44]), “knows the results of my child's visits to other doctors” (OR 2.02 [1.08–3.80]), and “always follows up on a problem my child has had, either at the next visit or by phone” (OR 6.20 [2.88–13.35]) and wanting one provider to coordinate all of the health care that the child receives (OR 3.28 [1.48–7.27]). Conclusions.—Greater continuity of primary care is associated with better care coordination as perceived by parents. Efforts to improve and maintain continuity may be justified.