Patient-Physician Relational Continuity and Health System Utilization among Patients in Alberta

Ceara Cunningham; Tanmay Patil; Rizwan Shahid; Alka B Patel; Scott Oddie

doi:10.12927/hcq.2020.26089

Patient-Physician Relational Continuity and Health System Utilization among Patients in Alberta

Healthc Q. 2020 Jan;22(4):13-21. doi: 10.12927/hcq.2020.26089.

Authors

Ceara Cunningham¹, Tanmay Patil², Rizwan Shahid³, Alka B Patel⁴, Scott Oddie⁵

Affiliations

¹ The assistant scientific director for the Primary Health Care Integration Network. She is also a scientist for Applied Research and Evaluation Services in the Primary Health Care Provincial Portfolio of Alberta Health Services. Additionally, she holds an adjunct assistant professor position in the Department of Community Health Sciences, Cumming School of Medicine, University of Calgary. Ceara can be reached by e-mail at ceara.cunningham@albertahealthservices.ca.
² A data analyst with Applied Research and Evaluation Services, Alberta Health Services. Tanmay provides support to a number of PCNs and internal AHS teams for projects involving quality improvement and project effectiveness.
³ Worked at Alberta Health Services since 2005 and is actively involved in applied geography research and the design and development of geographic information systems (GISs). He is also an adjunct assistant professor with the Department of Geography, University of Calgary, a GIS chartered geographer and a certified GIS professional.
⁴ The AHS director of health services research and innovation on the Applied Research and Evaluation Services team in Primary Health Care. Dr. Patel is currently an adjunct assistant professor with the Department of Community Health Sciences and co-leads the Geography of Health research group under the O'Brien Institute of Public Health at the University of Calgary.
⁵ The director of measurement and knowledge integration on the Applied Research and Evaluation Services team in the Primary Health Care Provincial Portfolio with Alberta Health Services. Dr. Oddie is also the RDC-AHS Health Research Collaborative Chair at Red Deer College. Dr. Oddie leads and supports initiatives that allow us to measure and assess the impact of primary healthcare initiatives across the province of Alberta.

PMID: 32073386
DOI: 10.12927/hcq.2020.26089

Abstract

In Alberta, no standardized processes exist to identify patients with chronic diseases (CDs) who do not have a family physician. This study examined the association between relational continuity (continuity of care) and healthcare utilization patterns in this population. Relational continuity was assessed using health administrative data to calculate a Usual Provider Continuity (UPC) Index. The majority of patients with no or a low UPC Index were male, did not have CD and were healthy or non-users of healthcare. When grouped by UPC Index, regression modelling revealed that emergency department visits and unplanned hospitalization declined with increased continuity of care. Advanced state of disease(s) and location of residence increased the likelihood of utilization of these services in the low- and moderate-continuity groups.

MeSH terms

Adult
Aged
Alberta
Chronic Disease*
Continuity of Patient Care / statistics & numerical data*
Emergency Service, Hospital / statistics & numerical data
Female
Hospitalization / statistics & numerical data
Humans
Male
Middle Aged
Physician-Patient Relations*
Primary Health Care / statistics & numerical data