Does continuity of care with a family physician reduce hospitalizations among older adults?

Abstract

Objective: To examine the relation between continuity of primary care and hospitalizations.

Methods: Survey data from a representative sample of older adults aged 67 or over living in the province of Manitoba (n = 1863) were linked to administrative data, which provide complete records of physician visits and hospitalizations. A visit-based measure of continuity of care was derived using a majority-of-care definition, whereby individuals who made 75% of all their visits to family physicians (FPs) to the same FP were classified as having high continuity of care, and those with less than 75% of their visits to the same FP as having low continuity of care. Whether individuals were hospitalized (for either ambulatory care-sensitive conditions or all conditions) was also determined from administrative records.

Results: High continuity of care was associated with reduced odds of ambulatory care-sensitive hospitalizations (adjusted odds ratio = 0.67, confidence interval 0.51-0.90) controlling for demographic and self-reported, health-related measures. It was not related to hospitalizations for all conditions, however.

Conclusions: The study highlights the importance of continuity of primary care in reducing potentially avoidable hospitalizations.