The achievement of continuity of care in a primary care training program

Although the importance of continuity in primary care is intuitively accepted by many authorities in medical education and health services, its value in terms of outcomes is not well proven. In spite of the relative lack of evidence, residency training programs in primary care are committed by accreditation boards to the implementation of a continuous clinical experience. The extent to which physicians in primary care training programs achieve continuity with their patients is not well established. This study, undertaken at the Family Practice Center at the University of North Carolina, was designed to measure the degree of continuity of care achieved by resident and faculty physicians over a one year period (July 1976 to June 1977). The results show that continuity of care for physicians, as defined by the proportion of his/her encounters that were assigned patients can be satisfactorily achieved in a primary care training program when compared to private practice. The extent to which patients saw their assigned physician appeared to increase with the number of visits, implying that people with acute problems (needing only one encounter) were less likely to experience continuity of physician than patients requiring regular contact for a chronic problem.