Evaluating Continuity of Care in Primary Care Internal Medicine Programs

Abstract

One goal of primary care training programs is to provide "continuity experiences" for residents. Although programs funded by the Health Resources Administration are mandated to provide and evaluate such experiences, a wide variety may exist in both the concept and the evaluation of continuity in these training programs. To investigate methods for evaluating this continuity experience, we surveyed 52 federally funded primary care internal medicine programs using a checklist of methods derived from the literature. Of the programs surveyed, 64% responded and all but two were evaluating continuity, most of them using several methods. Although it might be assumed that most programs would be assessing continuity in the ambulatory setting, most reported that "residents followed up assigned patients when admitted to the hospital." Assessment of continuity in the ambulatory setting, by determining the number of times the patient was seen by his assigned resident divided by total outpatient visits, ranked fourth behind "missed appointments" and "medical record audits." "Percentage of emergency room visits by assigned patients" was least frequently cited.