This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Abstract
Background. The benefits of continuity of care (COC) have not been firmly established for pediatric patients.
Objective. To assess whether greater COC is associated with lower emergency department (ED) utilization.
Setting. Outpatient teaching clinic at Children's Hospital and Regional Medical Center, Seattle, WA.
Patients. All 785 Medicaid managed care children ages 0 to 19 years followed at Children's Hospital and Regional Medical Center between 1993 to 1997 who had at least four outpatient visits.
Methods. Retrospective claims-based analysis. COC was quantified based on the number of different care providers in relation to the number of clinic visits.
Results. Attending COC was significantly greater than resident COC. In a multiple event survival analysis, compared with those patients in the lowest tertile of attending COC, those in the middle tertile had 30% lower ED utilization (hazard ratio 0.70 [0.53–0.93]) and those in the highest tertile had 35% lower ED use (hazard ratio 0.65 [0.50–0.80]). Resident COC was not significantly associated with ED use.
Conclusion. Greater COC with attending physicians in outpatient teaching clinics is associated with lower ED utilization.
- Received May 11, 1998.
- Accepted August 31, 1998.
- Copyright © 1999 American Academy of Pediatrics
Individual Login
Institutional Login
You may be able to gain access using your login credentials for your institution. Contact your librarian or administrator if you do not have a username and password.
Log in through your institution
Purchase access
In this issue
Jump to section
Related Articles
Cited By...
- Factors associated with inappropriate use of emergency departments: findings from a cross-sectional national study in France
- Association between continuity of provider-adjusted regularity of general practitioner contact and unplanned diabetes-related hospitalisation: a data linkage study in New South Wales, Australia, using the 45 and Up Study cohort
- Relation between family physician retention and avoidable hospital admission in Newfoundland and Labrador: a population-based cross-sectional study
- Effect of Continuity of Care on Emergency Department Visits in Elderly Patients with Asthma in Taiwan
- In California, Primary Care Continuity Was Associated With Reduced Emergency Department Use And Fewer Hospitalizations
- Linking Uninsured Patients Treated In The Emergency Department To Primary Care Shows Some Promise In Maryland
- Continuity of Care and Avoidable Hospitalizations for Chronic Obstructive Pulmonary Disease (COPD)
- Adverse events recorded in English primary care: observational study using the General Practice Research Database
- Continuity in the Provider of Home-Based Physical Therapy Services and Its Implications for Outcomes of Patients
- Nonurgent Emergency-Department Care: Analysis of Parent and Primary Physician Perspectives
- Emergency Department Reliance: A Discriminatory Measure of Frequent Emergency Department Users
- A Review of the Evidence for the Medical Home for Children With Special Health Care Needs
- The Association of Family Continuity with Infant Health Service Use
- Patients' Perceptions of Interpersonal Continuity of Care
- Cost and Utilization Analysis of a Pediatric Emergency Department Diversion Project
- Open Access in Primary Care: Results of a North Carolina Pilot Project
- Interpersonal Continuity of Care and Care Outcomes: A Critical Review
- Association Between Parental and Childhood Emergency Department Utilization
- Continuity of Care and Patient Satisfaction in a Family Practice Clinic
- Cultural Competence Policies and Other Predictors of Asthma Care Quality for Medicaid-Insured Children
- Behind Schedule: Improving Access to Care for Children One Practice at a Time
- Child and Adolescent Immunizations: New Recommendations, New Standards, New Opportunities
- Impact of Provider Continuity on Quality of Care for Persons With Diabetes Mellitus
- Defining and Measuring Interpersonal Continuity of Care
- An Innovative Proposal for the Health Care Financing System of the United States
- Continuity of Care for Children in Foster Care
- Impact of a Health Maintenance Organization Hospitalist System in Academic Pediatrics
- Continuity of Care Is Associated With High-Quality Careby Parental Report
- The dental home: A primary care oral health concept
- Comparison of Continuity in a Resident Versus Private Practice
- Association of Lower Continuity of Care With Greater Risk of Emergency Department Use and Hospitalization in Children
- Does Continuity of Care Reduce ED Visits?