Association of Lower Continuity of Care With Greater Risk of Emergency Department Use and Hospitalization in Children

摘要: Context. The benefits of continuity pediatric care remain controversial. Objective. To determine whether there is an association between having a continuous relationship with primary provider and decreased risk emergency department (ED) visitation hospitalization. Design. Retrospective cohort study. Setting Population. We used claims data from 46 097 patients enrolled at Group Health Cooperative, large staff-model health maintenance organization, January 1, 1993, December 31, 1998, for our analysis. be eligible, had to have been continuously least 2-year period or since birth made 4 visits one the Cooperative clinics. Main Exposure Variable. A (COC) index that quantifies degree which patient has experienced provider. Outcome Measures. ED utilization Results. Compared children highest COC, medium were more likely visited (hazard ratio [HR]: 1.28 [1.20–1.36]) hospitalized (HR: 1.22 [1.09–1.38]). Children lowest COC even 1.58 [1.49–1.66]) 1.54 [1.33–1.75]). These risks greater on Medicaid those asthma. Conclusions. Lower associated higher Efforts improve maintain may warranted.