Does continuity of care matter in a universally insured population?
Health Serv Res
; 40(2): 389-400, 2005 Apr.
Article
en En
| MEDLINE
| ID: mdl-15762898
ABSTRACT
OBJECTIVE:
To examine the relation between continuity of care and preventive health care and emergency department (ED) use in a universal health care system. DATA SOURCES/STUDYSETTING:
Administrative data that capture health care use of the entire population of a midwestern Canadian city. STUDYDESIGN:
A population-based, retrospective study of all individuals who had a least one physician contact in 1998 or 1999 (total N=536,893).METHODS:
Logistic regressions were conducted to examine the relation between continuity of care, defined in terms of the proportion of total visits to family physicians (FPs) made to the same FP, and cervical cancer screening, breast cancer screening, influenza vaccination, pneumococcal vaccination, and ED visits, controlling for demographic variables, socioeconomic status (defined in terms of relative affluence of neighborhood of residence), and health status. PRINCIPALFINDINGS:
Continuity of care was related to better preventive health care and reduced ED use. A consistent socioeconomic gradient also emerged. For instance, the odds of having a mammogram was double for individuals living in the wealthiest neighborhoods, relative to those in the poorest neighborhoods (adjusted odds ratio=2.31, 99 percent CI 2.13-2.50).CONCLUSIONS:
Having a long-term relationship with a single physician makes a difference even in a universal health care system. Moreover, socioeconomic disparities remain, suggesting the need to target specifically individuals from lower socioeconomic strata for preventive health care.
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Servicios Preventivos de Salud
/
Salud Urbana
/
Continuidad de la Atención al Paciente
/
Servicio de Urgencia en Hospital
/
Medicina Familiar y Comunitaria
/
Programas Nacionales de Salud
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Health Serv Res
Año:
2005
Tipo del documento:
Article