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Continuity of Care Impacts Patient-Doc Communication

Low continuity of care linked to reduced odds of excellent communication, shared decision making

FRIDAY, Nov. 22, 2013 (HealthDay News) -- For Veterans Administration (VA) outpatients, low continuity of primary care correlates with reduced quality of patient-provider communication, according to a study published online Sept. 26 in the Journal of General Internal Medicine.

David A. Katz, M.D., from the Iowa City VA Medical Center in Iowa, and colleagues examined the correlation between longitudinal continuity of care with the same primary care physician (PCP) and ratings of patient-provider communication in a study involving 4,393 VA outpatients participating in the Patient Aligned Care Team (PACT) initiative. Participants had at least three primary care visits to physicians or physician extenders during Fiscal Years 2009 and 2010, and following a primary care visit in Fiscal Year 2011, they completed the Survey of Healthcare Experiences of Patients.

The researchers found that, during the early stages of PACT implementation, Usual Provider of Continuity and Modified Modified Continuity Index (MMCI) continuity remained high (0.81). Low MMCI continuity correlated with reduced odds of excellent communication and shared decision making (odds ratio, 0.74 and 0.70, respectively) in multivariate models. The odds of excellent communication were also reduced with abbreviated duration of PCP care (less than one year: odds ratio, 0.35).

"By improving longitudinal continuity with the assigned PCP, while redesigning team-based roles, the PACT initiative has the potential to improve patient-provider communication," the authors write.

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