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J Gen Intern Med. 2008 Sep;23(9):1499-502. doi: 10.1007/s11606-008-0692-z. Epub 2008 Jun 19.

Primary care physician visit continuity: a comparison of patient-reported and administratively derived measures.

Author information

  • 1Department of Health Services, School of Public Health and Community Medicine, University of Washington, Seattle, WA 98195, USA. hrod@u.washington.edu

Abstract

BACKGROUND:

Studies find that primary care physician (PCP) visit continuity is positively associated with care quality. Some of the evidence base, however, relies on patient-reported continuity measures, which may be subject to response bias.

OBJECTIVE:

To assess the concordance of patient-reported and administratively derived visit continuity measures.

DESIGN:

Random samples of patients (n = 15,126) visiting 1 of 145 PCPs from a physician organization in Massachusetts were surveyed. Respondents reported their experienced visit continuity over the preceding 6 months. Usual Provider Continuity (UPC), an administratively derived measure, was calculated for each respondent. The concordance of patient reports and UPC was examined. Associations with patient-reported physician-patient interaction quality were assessed for both measures.

RESULTS:

Patient-reported and administratively derived visit continuity measures were moderately correlated for overall (r = 0.30) and urgent (r = 0.30) measures and modestly correlated for the routine (r = 0.17) measure. Although patient reports and UPC were significantly associated with the physician-patient interaction quality (p < 0.001), the effect size for patient-reports was approximately five times larger than the effect size for UPC.

CONCLUSIONS:

Studies and quality initiatives seeking to evaluate visit continuity should rely on administratively derived measures whenever possible. Patient-reported measures appear to be subject to biases that can overestimate the relationship between visit continuity and some patient-reported outcomes.

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PMID:
18563492
PMCID:
PMC2518030
DOI:
10.1007/s11606-008-0692-z
[PubMed - indexed for MEDLINE]
Free PMC Article
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