Select Journal or Resource JAMA & Archives Home JAMA Archives of   Dermatology   Facial Plastic Surgery   Family Medicine (1992-2000)   General Psychiatry   Internal Medicine   Neurology   Neurology and Psychiatry (1919-1959)   Ophthalmology   Otolaryngology—Head & Neck Surgery   Pediatrics & Adolescent Medicine   Surgery JAMA & Archives CME Calendar of Events JAMA Career Center For The Media JAMAevidence AMA Manual of Style Peer Review Congress JAMA-français

	Institution: CLOCKSS  | My Account | E-mail Alerts | Access Rights | Sign In Vol. 7 No. 4, July 1998   Archives  • Online Features Original Contribution  This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (134)  • Contact me when this article is cited  Related Content  • Similar articles in this journal The Role of Provider Continuity in Preventing Hospitalizations James M. Gill, MD, MPH; Arch G. Mainous III, PhD Arch Fam Med. 1998;7:352-357. Objectives  To examine the association between provider continuity and future hospitalization in a Medicaid population, and to determine if this association is greater for ambulatory care–sensitive conditions. Design  Analysis of paid claims to the Delaware Medicaid program during a 2-year period (July 1, 1993, to June 30, 1995). Continuity with a single provider during year 1 of the study was computed for each participant. Participants  A total of 13495 continuously enrolled fee-for-service Medicaid patients aged 0 to 64 years who had made at least 3 ambulatory physician visits during the first year of the study. Main Outcome Measure  Likelihood of hospitalization in year 2 of the study for all conditions and for ambulatory care–sensitive conditions. Results  The mean continuity score was 0.50 in year 1 and 11.9% of patients were hospitalized in year 2. After controlling for demographics, number of ambulatory visits, and case mix, higher provider continuity was associated with a lower likelihood of hospitalization for any condition (odds ratio [OR]=0.56; 95% confidence interval [CI], 0.46-0.69). For chronic ambulatory care–sensitive conditions there was a similar association between provider continuity and hospitalization (OR=0.54; 95% CI, 0.34-0.88), but for acute ambulatory care–sensitive conditions there was no significant association (OR=0.80; 95% CI, 0.48-1.34). Conclusions  Continuity of care with a provider is associated with a decreased future likelihood of hospitalization in the Delaware Medicaid population. This suggests that policies that encourage patients to concentrate their care with a single provider may lead to lower hospitalization rates and possibly lower health care costs. This study does not support the hypothesis that a certain set of conditions are particularly ambulatory care sensitive. From the Department of Family and Community Medicine, Christiana Care Health System, Wilmington, Del (Dr Gill); and the Department of Family Practice, University of Kentucky, Lexington (Dr Mainous). THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES Trends in hospitalizations for primary care sensitive conditions following the implementation of Family Health Teams in Belo Horizonte, Brazil Mendonca et al. Health Policy Plan 2011;0:czr043v1-czr043. ABSTRACT | FULL TEXT   Does continuity of care matter in a health care system that lacks referral arrangements? Cheng et al. Health Policy Plan 2011;26:157-162. ABSTRACT | FULL TEXT   Older Adults' Inpatient and Emergency Department Utilization for Ambulatory-Care-Sensitive Conditions: Relationship With Alcohol Consumption Merrick et al. J Aging Health 2011;23:86-111. ABSTRACT   Continuity of care is good for elderly people with diabetes: Retrospective cohort study of mortality and hospitalization Worrall and Knight cfp 2011;57:e16-e20. ABSTRACT | FULL TEXT   Missed Well-Child Care Visits, Low Continuity of Care, and Risk of Ambulatory Care-Sensitive Hospitalizations in Young Children Tom et al. Arch Pediatr Adolesc Med 2010;164:1052-1058. ABSTRACT | FULL TEXT   A Longitudinal Examination of Continuity of Care and Avoidable Hospitalization: Evidence From a Universal Coverage Health Care System Cheng et al. Arch Intern Med 2010;170:1671-1677. ABSTRACT | FULL TEXT   Prospects For Rebuilding Primary Care Using The Patient-Centered Medical Home Landon et al. Health Aff (Millwood) 2010;29:827-834. ABSTRACT | FULL TEXT   The Role of Usual Source of Care in Cholesterol Treatment Winters et al. J Am Board Fam Med 2010;23:179-185. ABSTRACT | FULL TEXT   Continuity of diabetes care is associated with avoidable hospitalizations: evidence from Taiwan's National Health Insurance scheme Lin et al. Int J Qual Health Care 2010;22:3-8. ABSTRACT | FULL TEXT   Does Having a Personal Physician Improve Quality of Care in Diabetes? Hueston J Am Board Fam Med 2010;23:82-87. ABSTRACT | FULL TEXT   Continuity of Outpatient and Inpatient Care by Primary Care Physicians for Hospitalized Older Adults Sharma et al. JAMA 2009;301:1671-1680. ABSTRACT | FULL TEXT   Continuity of Care and Intensive Care Unit Use at the End of Life Sharma et al. Arch Intern Med 2009;169:81-86. ABSTRACT | FULL TEXT   An Investment in Health: Anticipating the Cost of a Usual Source of Care for Children Birken and Mayer Pediatrics 2009;123:77-83. ABSTRACT | FULL TEXT   Effect of 80-Hour Workweek on Continuity of Care McBurney et al. CLIN PEDIATR 2008;47:803-808. ABSTRACT   The Association of Family Continuity with Infant Health Service Use Clark et al. J Am Board Fam Med 2008;21:385-391. ABSTRACT | FULL TEXT   Effects of Quality on Outcomes in Primary Care: A Review of the Literature Hsiao and Boult American Journal of Medical Quality 2008;23:302-310. ABSTRACT   Continuity-Structured Clinical Observations: Assessing the Multiple-Observer Evaluation in a Pediatric Resident Continuity Clinic Zimmer et al. Pediatrics 2008;121:e1633-e1645. ABSTRACT | FULL TEXT   Effects of Continuity of Care in Infancy on Receipt of Lead, Anemia, and Tuberculosis Screening Flores et al. Pediatrics 2008;121:e399-e406. ABSTRACT | FULL TEXT   Patient psychosocial factors and primary care consultation: a cohort study Bellon et al. Fam Pract 2007;24:562-569. ABSTRACT | FULL TEXT   Continuity of primary care and emergency department utilization among elderly people Ionescu-Ittu et al. CMAJ 2007;177:1362-1368. ABSTRACT | FULL TEXT   Do HMOs Reduce Preventable Hospitalizations for Medicare Beneficiaries? Basu and Mobley Med Care Res Rev 2007;64:544-567. ABSTRACT   Patients' Perceptions of Interpersonal Continuity of Care Pandhi and Saultz J Am Board Fam Med 2006;19:390-397. ABSTRACT | FULL TEXT   Indices for Continuity of Care: A Systematic Review of the Literature Jee and Cabana Med Care Res Rev 2006;63:158-188. ABSTRACT   Enrolling Vulnerable, Uninsured but Eligible Children in Public Health Insurance: Association With Health Status and Primary Care Access Stevens et al. Pediatrics 2006;117:e751-e759. ABSTRACT | FULL TEXT   Continuity of care in medication management: Review of issues and considerations for pharmacy the ASHP Continuity of Care Task Force Am J Health Syst Pharm 2005;62:1714-1720. FULL TEXT   An Update On Safety-Net Hospitals: Coping With The Late 1990s And Early 2000s Bazzoli et al. Health Aff (Millwood) 2005;24:1047-1056. ABSTRACT | FULL TEXT   Interpersonal Continuity of Care and Care Outcomes: A Critical Review Saultz and Lochner Ann Fam Med 2005;3:159-166. ABSTRACT | FULL TEXT   When Do Older Patients Change Primary Care Physicians? Mold et al. J Am Board Fam Med 2004;17:453-460. ABSTRACT | FULL TEXT   Physician-Patient Relationship and Medication Compliance: A Primary Care Investigation Kerse et al. Ann Fam Med 2004;2:455-461. ABSTRACT | FULL TEXT   Primary Care Pediatrics: 2004 and Beyond Cheng Pediatrics 2004;113:1802-1809. FULL TEXT   Familiarity breeds neglect? Unanticipated benefits of discontinuous primary care Broom Fam Pract 2003;20:503-507. ABSTRACT | FULL TEXT   Continuity of Care: Process or Outcome? Christakis Ann Fam Med 2003;1:131-133. FULL TEXT   Defining and Measuring Interpersonal Continuity of Care Saultz Ann Fam Med 2003;1:134-143. ABSTRACT | FULL TEXT   Provider Continuity in Family Medicine: Does It Make a Difference for Total Health Care Costs? De Maeseneer et al. Ann Fam Med 2003;1:144-148. ABSTRACT | FULL TEXT   Continuity of Primary Care: To Whom Does It Matter and When? Nutting et al. Ann Fam Med 2003;1:149-155. ABSTRACT | FULL TEXT   On Being New to an Insurance Plan: Health Care Use Associated With the First Years in a Health Insurance Plan Franks et al. Ann Fam Med 2003;1:156-161. ABSTRACT | FULL TEXT   Impact of Provider Continuity on Quality of Care for Persons With Diabetes Mellitus Gill et al. Ann Fam Med 2003;1:162-170. ABSTRACT | FULL TEXT   Continuity of Care and Recognition of Diabetes, Hypertension, and Hypercholesterolemia Koopman et al. Arch Intern Med 2003;163:1357-1361. ABSTRACT | FULL TEXT   Quality-of-Care Indicators for Early-Stage Prostate Cancer Spencer et al. JCO 2003;21:1928-1936. ABSTRACT | FULL TEXT   Towards a theory of continuity of care Gray et al. JRSM 2003;96:160-166. FULL TEXT   Racial and Ethnic Disparities in the Primary Care Experiences of Children: A Review of the Literature Stevens and Shi Med Care Res Rev 2003;60:3-30. ABSTRACT   Continuity of Care for Children in Foster Care DiGiuseppe and Christakis Pediatrics 2003;111:e208-e213. ABSTRACT | FULL TEXT   Continuity of Care Is Associated With High-Quality Careby Parental Report Christakis et al. Pediatrics 2002;109:e54-e54. ABSTRACT | FULL TEXT   Comparison of Continuity in a Resident Versus Private Practice Darden et al. Pediatrics 2001;108:1263-1268. ABSTRACT | FULL TEXT   Continuity of Care: A Reconceptualization Donaldson Med Care Res Rev 2001;58:255-290. ABSTRACT   Fix what's wrong, not what's right, with general practice in Britain De Maeseneer et al. BMJ 2000;320:1616-1617. FULL TEXT   Fragmentation of Patient Care Between Chiropractors and Family Physicians Mainous III et al. Arch Fam Med 2000;9:446-450. ABSTRACT | FULL TEXT   The Effect of Continuity of Care on Emergency Department Use Gill et al. Arch Fam Med 2000;9:333-338. ABSTRACT | FULL TEXT   HOME | CURRENT ISSUE | PAST ISSUES | TOPIC COLLECTIONS | CME | PHYSICIAN JOBS | HELP CONDITIONS OF USE | PRIVACY POLICY | CONTACT US | SITE MAP   © 1998 American Medical Association. All Rights Reserved.