Measuring the Value-Functions of Primary Care: Provider Level Continuity of Care Measure
Identifying Attributes
Care Settings
Country
Publishing Organisation
Type of Quality Indicator
IOM Quality Dimension
Domain
Defining Attributes
Definition
This is a process measure evaluating primary care physicians; for each physician, their denominator is all of the patients they saw during the evaluation period who had at least 2 PCP visits (could include visits to other PCPs), and the numerator is the number of those patients whose Bice-Boxerman Continuity of Care Index is >= 0.7. The Bice-Boxerman index is a validated measure of patient-level care continuity that ranges from 0 to 1; 0 reflects completely disjointed care (a different provider for each visit) and 1 reflects complete continuity with the same provider for all visits.
Numerator
The number of patients with a continuity index of at least 0.7.
Denominator
The total number of patients with continuous enrolment with at least 2 visits to any primary care physicians in the measurement period. The requirement of continuous enrolment ensures that all of the patient encounters will be captured in the data, and the requirement of at least 2 visits is necessary to calculate a Continuity of Care index (the notion of "continuity" isn't applicable to someone who only has 1 physician visit, i.e., there needs to be at least 2 visits to determine if they consistently visit the same or different physicians).
Exclusions
Since Continuity of Care is about seeing the same clinician, we did not consider patients with only one visit as an exclusion, therefore; we do not have any denominator exclusions.
Use of Risk Adjustment
Risk Adjustments
None
Stratifications
None
Collection and Reporting Attributes
Type of Data Collection
Data Collection Methods
Claims data