Continuity of care and the physician-patient relationship - The importanceof continuity for adult patients with asthma

BACKGROUND We assessed the role and importance of continuity of care in pre dicting the perceptions of the physician-patient relationship held by patie nts with asthma, METHODS We analyzed the 1997 statewide probability survey of adult Kentucky Medicaid recipients. The participants included 1726 respondents with 2 or more visits to a physician's office, clinic, or emergency department in the previous 12 months. Of these, 404 reported having asthma. The respondents used 5-point single-item scales to rate continuity of care, provider commun ication, and patient influence over treatment. RESULTS Multivariate linear regression analyses were used to assess the con tribution of continuity of care to provider communication and Patient influ ence in the presence of control variables. Those variables included age, se x, education, race, number of visits, general health, health improvement, a nd life satisfaction For persons with asthma, continuity of care was the on ly variable that significantly contributed to the provider communication mo del (P=.01) and the only variable other than life satisfaction that contrib uted to the patient influence model (P<.05 for each). For patients who did not have asthma, continuity of care was one of several variables contributi ng significantly (P<.05) to the provider communication and patient influenc e models. CONCLUSIONS Particularly fur patients with asthma, continuity of care a;as linked to patient evaluations of their interaction with the physician. Beca use of this, changes in health care systems that promote discontinuity with individual physicians may be particularly disruptive for patients with chr onic diseases.