Relationship of physician continuity to type of health problems in primary care.

The objective of this study was to determine if the level of continuity of medical care was related to the type of health problems (chronic or acute) presented by patients at four family health centers during a one-year period. Patients with chronic diagnoses encountered significantly fewer physicians and had a higher mean Continuity Index than patients with acute illness diagnoses, even though these two groups made the same number of health center visits for their respective problems during this period. These findings indicate that the prioritizing of clinical problems (whether planned or fortuitous) with respect to the importance of providing continuous care may already be taking place at these health centers. These activities are appropriate if one accepts the premise that, other things being equal, longer illnesses are treated more effectively if there is a consistent knowledge base about a patient and his/her illness, and that this consistency of knowledge is related to the number of providers encountered by that patient.