This study aims to describe levels and distribution of the continuity of primary care among child and adolescent patients who are 2-19 years old, and analyze the effects of it on the risk of hospitalization.
Study population was 2-19 year old child and adolescent patients as of 2002, who had more than three ambulatory care visits in the years of 2002-3 and whose most frequent provider was the primary care practices (189,660 persons). Association of levels of primary care with the risk of hospitalization was evaluated using multiple event survival analysis. Outcome variables were whether the patient had hospitalized or not, and whether the patient had hospitalized due to ambulatory care-sensitive conditions or not.
Multiple event survival analysis revealed statistically significant association of the levels of primary care with the risk of hospitalization. Hazard ratio was 1.34[1.27-1.41] at the medium level of continuity and 1.47[1.39-1.55] at the lower level where outcome variable was whether the patient had been hospitalized or not. Hazard ratios were 1.35[1.21-1.50] at the medium level of continuity and 1.60[1.44-1.78] at the lower level, where outcome variable was whether the patient been had hospitalized due to ambulatory care-sensitive conditions or not.
This study produced some evidences on the benefits of continuity of care, which will in turn support the introduction of personal doctor registration program in the future.