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Home Research Research Library Higher Primary Care Physician Continuity is Associated With Lower Costs and Hospitalizations Higher Primary Care Physician Continuity is Associated With Lower Costs and Hospitalizations 2018 Author(s) Bazemore, Andrew W, Petterson, Stephen M, Peterson, Lars E, Bruno, R, Chung, YoonKyung, and Phillips, Robert L Topic(s) Role of Primary Care, and Achieving Health System Goals Keyword(s) Cost Of Care, and Quality Of Care Volume Annals of Family Medicine Source Annals of Family Medicine PURPOSE Continuity of care is a defining characteristic of primary care associated with lower costs and improved health equity and care quality. However, we lack provider-level measures of primary care continuity amenable to value-based payment, including the Medicare Quality Payment Program (QPP). We created 4 physician-level, claims-based continuity measures and tested their associations with health care expenditures and hospitalizations. METHODS We used Medicare claims data for 1,448,952 beneficiaries obtaining care from a nationally representative sample of 6,551 primary care physicians to calculate continuity scores by 4 established methods. Patient-level continuity scores attributed to a single physician were averaged to create physician-level scores. We used beneficiary multilevel models, including beneficiary controls, physician characteristics, and practice rurality to estimate associations with total Medicare Part A & B expenditures (allowed charges, logged), and any hospitalization. RESULTS Our continuity measures were highly correlated (correlation coefficients ranged from 0.86 to 0.99), with greater continuity associated with similar outcomes for each. Adjusted expenditures for beneficiaries cared for by physicians in the highest Bice-Boxerman continuity score quintile were 14.1% lower than for those in the lowest quintile ($8,092 vs $6,958; β = –0.151; 95% CI, –0.186 to –0.116), and the odds of hospitalization were 16.1% lower between the highest and lowest continuity quintiles (OR = 0.839; 95% CI, 0.787 to 0.893). CONCLUSIONS All 4 continuity scores tested were significantly associated with lower total expenditures and hospitalization rates. Such indices are potentially useful as QPP measures, and may also serve as proxy resource-use measures, given the strength of association with lower costs and utilization. ABFM Research Read all 2014 Effectiveness over efficiency: underestimating the primary care physician shortage Go to Effectiveness over efficiency: underestimating the primary care physician shortage 2016 How Other Countries Use Deprivation Indices-And Why The United States Desperately Needs One Go to How Other Countries Use Deprivation Indices-And Why The United States Desperately Needs One 2025 The Association Between Residency Characteristics and Graduates Caring for Children: A Family Medicine Residency Outcomes Project Go to The Association Between Residency Characteristics and Graduates Caring for Children: A Family Medicine Residency Outcomes Project 2016 Intended vs Reported Scope of Practice–Reply Go to Intended vs Reported Scope of Practice–Reply
Author(s) Bazemore, Andrew W, Petterson, Stephen M, Peterson, Lars E, Bruno, R, Chung, YoonKyung, and Phillips, Robert L Topic(s) Role of Primary Care, and Achieving Health System Goals Keyword(s) Cost Of Care, and Quality Of Care Volume Annals of Family Medicine Source Annals of Family Medicine
ABFM Research Read all 2014 Effectiveness over efficiency: underestimating the primary care physician shortage Go to Effectiveness over efficiency: underestimating the primary care physician shortage 2016 How Other Countries Use Deprivation Indices-And Why The United States Desperately Needs One Go to How Other Countries Use Deprivation Indices-And Why The United States Desperately Needs One 2025 The Association Between Residency Characteristics and Graduates Caring for Children: A Family Medicine Residency Outcomes Project Go to The Association Between Residency Characteristics and Graduates Caring for Children: A Family Medicine Residency Outcomes Project 2016 Intended vs Reported Scope of Practice–Reply Go to Intended vs Reported Scope of Practice–Reply
2014 Effectiveness over efficiency: underestimating the primary care physician shortage Go to Effectiveness over efficiency: underestimating the primary care physician shortage
2016 How Other Countries Use Deprivation Indices-And Why The United States Desperately Needs One Go to How Other Countries Use Deprivation Indices-And Why The United States Desperately Needs One
2025 The Association Between Residency Characteristics and Graduates Caring for Children: A Family Medicine Residency Outcomes Project Go to The Association Between Residency Characteristics and Graduates Caring for Children: A Family Medicine Residency Outcomes Project