Dimitri A Christakis1, Jeffrey A Wright. 1. Department of Pediatrics and the Child Health Institute, University of Washington, Seattle, 98115-8160, USA. dachris@u.washington.edu
Abstract
CONTEXT: Although continuity of care is an important component of primary care, few mechanisms for improving it have been studied. OBJECTIVE: To determine if automated reminders to providers and patient schedulers can improve continuity of care in a practice. DESIGN: Prospective randomized controlled trial. SETTING AND POPULATION: Four hundred and nine patients in the lowest tertile of continuity of care in a university-affiliated clinic with a computerized information system were randomized to 1 of 4 groups: 1) control (no reminder), 2) provider alert, 3) scheduler alert, or 4) provider and scheduler alert. MAIN OUTCOME MEASURES: Continuity of care as measured by a previously described dispersion index that ranges from 0 to 1.Results.-Initial continuity of care was.134 (standard deviation,.07). In a linear regression model, 9 months after implementation of the system, both the provider-prompt group (.027 [.006,.05]) and the provider and scheduler group (.024 [.001,.054]) were associated with increased continuity compared with the control group CONCLUSIONS: Prompting providers for patients with poor continuity of care may improve it.
RCT Entities:
CONTEXT: Although continuity of care is an important component of primary care, few mechanisms for improving it have been studied. OBJECTIVE: To determine if automated reminders to providers and patient schedulers can improve continuity of care in a practice. DESIGN: Prospective randomized controlled trial. SETTING AND POPULATION: Four hundred and nine patients in the lowest tertile of continuity of care in a university-affiliated clinic with a computerized information system were randomized to 1 of 4 groups: 1) control (no reminder), 2) provider alert, 3) scheduler alert, or 4) provider and scheduler alert. MAIN OUTCOME MEASURES: Continuity of care as measured by a previously described dispersion index that ranges from 0 to 1.Results.-Initial continuity of care was.134 (standard deviation,.07). In a linear regression model, 9 months after implementation of the system, both the provider-prompt group (.027 [.006,.05]) and the provider and scheduler group (.024 [.001,.054]) were associated with increased continuity compared with the control group CONCLUSIONS: Prompting providers for patients with poor continuity of care may improve it.
Authors: Calvin L Colvin; Monika M Safford; Paul Muntner; Lisandro D Colantonio; Lisa M Kern Journal: Am J Manag Care Date: 2022-03 Impact factor: 3.247
Authors: Lisa M Kern; Joanna B Ringel; Mangala Rajan; Lisandro D Colantonio; Lawrence P Casalino; Laura C Pinheiro; Evgeniya Reshetnyak; Monika M Safford Journal: Med Care Date: 2021-04-01 Impact factor: 3.178
Authors: Lisa M Kern; Mangala Rajan; Lisandro D Colantonio; Evgeniya Reshetnyak; Joanna Bryan Ringel; Paul M Muntner; Lawrence P Casalino; Laura C Pinheiro; Monika M Safford Journal: BMC Health Serv Res Date: 2021-02-17 Impact factor: 2.655