The importance of continuity of care in the likelihood of future hospitalization: is site of care equivalent to a primary clinician?

Abstract

Objectives: This study examined the effect of continuity with clinicians and health care sites on likelihood of future hospitalization.

Methods: Delaware Medicaid patient data were analyzed. Logistic regression models supplied adjusted effects of continuity on hospitalization.

Results: Patients in the high clinician continuity group had lower odds of hospitalization than patients in the high site/low clinician continuity group (odds ratio [OR] = 0.75, 95% confidence interval [CI] = 0.66, 0.87). The latter group did not differ from the low site/low clinician continuity group (OR = 0.93, 95% CI = 0.80, 1.08).

Conclusions: A location providing health care without clinician continuity may not be sufficient to ensure cost-effective care.