Continuity of Infant Well Care in a Community Health Center Resident Clinic

Achieving patient continuity in resident continuity clinic is challenging. Patients, residents and primary care providers (PCP) benefit from this ongoing relationship. We examined rates of continuity of infant well care for first year pediatric residents (PL1) and associated factors in three clinics (W, E and K) in a community health center system. We collected the number of infants who had PL1 PCPs for academic years 2010, 2011 and 2012 and patient demographic data. We measured continuity using the usual provider of care method. We assessed rates of continuity, total numbers of infants and factors associated with continuity and medical home by Chi Square, ANOVA, Student's t test and multivariate linear regression (SPSS version 21). 115 patients had a PL1 PCP and attended 408 visits with 19 residents. The mean number of infants seen per PL1 in each clinic was W 7.8 +/- 2.2, E 3.8 +/- 1.5 and K 3.7 +/- 2.9 (p<.01). PL1 continuity percentage was 66% at W, 47% at E and 54% at K (p<.01). Total continuity of care for all providers at W was 70%, E 65% and K 60% (p<.01 W vs. K only). In multivariate linear regression, only continuity of care for all providers was associated with mean PL1 continuity with of 2.24 (95% CI 1.13-3.34), p<.001. PL1 continuity differed significantly between clinic sites. The only predictor of PL1 well care continuity was total clinic continuity of care. Maximizing continuity through the Medical Home practice was significantly associated with increased resident continuity of care.