Continuity of care and patient satisfaction in a family practice clinic

Background: Continuity is a tenant central to family practice. Continuity is associated with improved satisfaction in populations that can easily change providers. However, little is known about the importance of continuity where patients are assigned providers. Methods: A pretested survey was distributed to patients of a family practice residency clinic in a military medical center for a week's period. Results were analyzed using chi(2), unpaired t test, correlation matrices, and linear regression for patient satisfaction. Results: The response rate was 68.3%. Responders were not more likely to be seeing their primary care provider (PCP). Regression analysis revealed that 12% of patient satisfaction was associated with long-term continuity rates, 23% by PCP satisfaction, and 17% by how easy it was to make the appointment. For high clinic users (> 10 visits/year), 78% of patient satisfaction is determined by PCP satisfaction and long-term continuity rates. A subset of patients (13%) values choice of appointment time or other providers over PCP continuity. Satisfaction is not diminished in this group despite low long-term continuity ( P <.05 for all results). Conclusions: Patient satisfaction is associated with continuity, especially for high clinic users. Although continuity is important, a subset of patients values the ability to see other providers and to change providers.