1. The Research Question
Continuity of care: does having the same primary care provider over time matter? S.T. Wong, A. Katz, Peterson, S., & Taylor, C.
Does high continuity of care predict:
a) patient reported experiences of care?
b) patient reported impacts of primary care?
Why this is important?
Important measure of primary care performance
Previous data: Associated with lower health care costs and improved outcomes (e.g. fewer hospitalizations, better medication adherence, disclosure of behavioral concerns)
Continuity of care: does having the same primary care provider over time matter? (Oral Presentation On Completed Research) Sabrina Wong, RN, PhD, University of British Columbia Centre for Health Services and Policy Research and School of Nursing; Alan Katz, MD, University of Manitoba, Manitoba Centre for Health Policy; Sandra Peterson, MSc, UBC Centre for Health Services and Policy Research; Carole Taylor, MSc, University of Manitoba, Manitoba Centre for Health Policy

2. What the Researchers Did
Population/Subjects:
2176 adults aged years who spoke English, French, Chinese, or Punjabi living across British Columbia and Manitoba
Design: retrospective population-based cohort
Methods:
Random digit dial survey (patient experience)
Linked survey to patient’s administrative data (to derive a continuity of care -CC- index), N=1609 agreed to linkage

3. What the Researchers Found
Majority of patients have high CC; CC associated with older age, chronic conditions, higher score on ADG and female gender
CC predictive of
doctor’s knowledge of patient
shared decision-making
confidence & satisfaction
No predictive for interpersonal processes of care or patient activation
ADGs-Aggregated Diagnosis Groups-- ref:
Aggregated Diagnosis Groups (ADGs) continue to be part of the Johns Hopkins Adjusted Clinical Group® (ACG®) case-mix system. The ACG System groups every ICD-9 and ICD-10 diagnosis code assigned to a patient into one of 32 different ADGs based on five clinical and expected utilization criteria:
duration of the condition (acute, recurrent, or chronic);
severity of the condition (e.g., minor and stable versus major and unstable);
diagnostic certainty (symptoms focusing on diagnostic evaluation versus documented disease focusing on treatment services);
etiology of the condition (infectious, injury, or other); and
specialty care involvement (medical, surgical, obstetric, haematology, etc.).

4. What This Means for Clinical Practice
Higher continuity of care is important for influencing:
Some patient experiences
Confidence that people can obtain and use care when needed
Higher continuity of care won’t necessarily help patients acquire the skills, knowledge, or confidence to manage their health on a day-to-day basis