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Cited by 110Primary Care and Health OutcomesHealth Promotion and Cardiovascular PreventionHealthcare Policy and Management

Does Continuity of Care Matter in a Universally Insured Population?

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Menec, Verena H., Sirski, Monica, Attawar, Dhiwya·2005·Health Services Research
DOI 10.1111/j.1475-6773.2005.0p364.xPMC PMC1361147
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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/Study Setting.Administrative data that capture health care use of the entire population of a midwestern Canadian city. Study Design.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. Principal Findings.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.

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Authors
Menec, V. H., Sirski, M., & Attawar, D.
Affiliations
University of Manitoba (CA)
Corresponding author
Menec, Verena H.
ORCID
Menec, Verena H.
Venue
Health Services Research
Publisher
Wiley
Published
2005-03-10
Volume
40
Issue
2
Pages
389-400
ISSN
  • 0017-9124 (ISSN-L)
  • 1475-6773
DOI
10.1111/j.1475-6773.2005.0p364.x
PMC
PMC1361147
OpenAlex
W3048754223
Cited by
110
References
29
Citations by year
2026: 1 · 2025: 3 · 2023: 2 · 2022: 8 · 2021: 1 · 2020: 4 · 2019: 2 · 2018: 5 · 2017: 7 · 2016: 5 · 2015: 6 · 2014: 8 · 2013: 7 · 2012: 7
FWCI
16.14
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Health Services Research (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed
Funders
Canadian Institutes of Health Research
Topics
  • Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
Keywords
continuity of care, universal health care, preventive medicine, emergency department utilization, general practitioners, cervical cancer screening, breast cancer screening, influenza vaccination, pneumococcal vaccination, socioeconomic disparities, neighborhood affluence, physician-patient relationship
MeSH terms
Adult, Aged, Continuity of Patient Care, Emergency Service, Hospital, Family Practice, Female, Health Services Accessibility, Health Services Research, Humans, Male, Manitoba, Middle Aged, National Health Programs, Poverty Areas, Preventive Health Services, Professional-Patient Relations, Residence Characteristics, Retrospective Studies, Socioeconomic Factors, Urban Health, Confidence Intervals, Logistic Models, Odds Ratio

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