Influence of organization and demographic characteristics of primary care practices on continuity of care: analysis of a retrospective cohort from 287 primary care practices covering about 6 million people in Catalonia

Autor: Leonardo Méndez, Mència Benítez, Mireia Fàbregas, Albert Mercadé, Ermengol Coma, Francesc Fina, Paula Peremiquel-Trillas, Manuel Medina, Núria Mora
Přispěvatelé: Institut Català de la Salut, [Coma E, Méndez L, Mercadé A] Sistemes d’Informació dels Serveis d’Atenció Primària (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain. [Mora N] Sistemes d’Informació dels Serveis d’Atenció Primària (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain. Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain. [Peremiquel-Trillas P] Servei de Medicina Preventiva i Epidemiologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Unit of Molecular Epidemiology and Genetics in Infections and Cancer, IDIBELL, Catalan Institute of Oncology, L’Hospitalet de Llobregat, Barcelona, Spain. [Benítez M] Sistemes d’Informació dels Serveis d’Atenció Primària (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain. Equip d’Atenció Primària Gòtic, Institut Català de La Salut (ICS), Barcelona, Spain, Vall d'Hebron Barcelona Hospital Campus
Rok vydání: 2021
Předmět:
Multivariate statistics
Catalonia
Index (economics)
media_common.quotation_subject
Bivariate analysis
03 medical and health sciences
Population health management
0302 clinical medicine
Rurality
Health service research
Cataluña
Demografia - Catalunya
Linear regression
Humans
Medicine
Health Services Administration::Patient Care Management::Comprehensive Health Care::Primary Health Care [HEALTH CARE]
030212 general & internal medicine
Healthcare services utilization
Population Studies in Public Health::Demography [PUBLIC HEALTH]
Relacions metge-pacient
Demography
Retrospective Studies
Primary health care
media_common
lcsh:R5-920
Patient-physician relationship
Variables
business.industry
030503 health policy & services
Continuity of patient care
Primary care physician
Retrospective cohort study
Atenció primària - Catalunya
Primary care
Estudios Poblacionales en Salud Pública::demografía [SALUD PÚBLICA]
Patient care management
Atenció primària
Spain
Physician and patient
administración de los servicios de salud::gestión de la atención al paciente::atención integral de salud::atención primaria de la salud [ATENCIÓN DE SALUD]
lcsh:Medicine (General)
0305 other medical science
Family Practice
business
Research Article
Zdroj: BMC Family Practice, Vol 22, Iss 1, Pp 1-7 (2021)
Dipòsit Digital de la UB
Universidad de Barcelona
BMC Family Practice
Scientia
ISSN: 1471-2296
DOI: 10.1186/s12875-021-01414-y
Popis: Background There is evidence that an ongoing patient-physician relationship is associated with improved health outcomes and more efficient health systems. The main objective of this study is to describe the continuity of care in primary healthcare in Catalonia (Spain) and to analyze whether the organization of primary care practices (PCP) or their patients’ sociodemographic characteristics play a role in its continuity of care. Methods Four indices were used to measure continuity of care: Usual Provider Index (UPC), Modified Modified Continuity Index (MMCI), Continuity of Care Index (COC), and Sequential Continuity Index (SECON). The study was conducted on 287 PCP of the Catalan Institute of Health (Institut Català de la Salut—ICS). Each continuity of care index was calculated at the patient level (3.2 million patients and 35.5 million visits) and then aggregated at the PCP level. We adjusted linear regression models for each continuity index studied, considering the result of the index as an independent variable and demographic and organizational characteristics of the PCP as explanatory variables. Pearson correlation tests were used to compare the four continuity of care indices. Results Indices’ results were: UPC: 70,5%; MMCI: 73%; COC: 53,7%; SECON: 60,5%. The continuity of care indices had the highest bivariate correlation with the percentage of appointments booked with an assigned health provider (VISUBA variable: the lower the value, the higher the visits without an assigned health provider, and thus an organization favoring immediate consultation). Its R2 ranged between 56 and 63%, depending on the index. The multivariate model which explained better the variability of continuity of care indices (from 49 to 56%) included the variables VISUBA and rurality with a direct relationship; while the variables primary care physician leave days and training practices showed an inverse relationship. Conclusion Study results suggest that an organization of primary care favoring immediate consultation is related to a lower continuity of patient care.
Databáze: OpenAIRE
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