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UBC Theses and Dissertations
Relationship between continuity of care and emergency department utilization in children with attention deficit/hyperactivity disorder in British Columbia Mozel, Michelle R.
Abstract
Cxjntmuity of care with a primary care provider has long been thought to lead to improved health outcomes and greater patient and physician satisfaction. The benefits of continuity of care remain controversial, however, and have not been firmly established for pediatric patients. The objective of this study was to examine whether continuity of care with a primary care provider is associated with the number of emergency department (ED) visits in children and adolescents with a diagnosis of attention-deficit/hyperactivity disorder (ADHD) in British Columbia We analyzed two years of physician claims records for over 4000 British Columbia children aged 4 to 16 to determine individual continuity of care (COC) scores for each study participant. Multinomial logistic regression analysis was then applied to determine if a relationship exists between COC computed during two years and number of ED visits made during the following year. Our results showed a weak association between continuity with a primary care provider and ED use. In multivariate analysis, continuity was associated with a lower likelihood of making a single ED visit (odds ratio, 0.85; 95% confidence interval, 0.70- 1.05) and is more strongly associated with a lower likelihood of making multiple E D visits (odds ratio, 0.81; 95% confidence interval, 0.62-1.05). Other variables that were associated with outcome include: age, socio-economic status, overall number of general practitioner visits, pediatrician visits, psychiatrist visits, and illness burden. This study demonstrates that high primary care provider continuity is associated with lower ED use for children aged 4 to 16 with ADHD in British Columbia. The results suggest that strategies to improve continuity of primary care provider among this population may lead to decreased ED utilization and should therefore be encouraged.
Item Metadata
Title |
Relationship between continuity of care and emergency department utilization in children with attention deficit/hyperactivity disorder in British Columbia
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Creator | |
Publisher |
University of British Columbia
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Date Issued |
2001
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Description |
Cxjntmuity of care with a primary care provider has long been thought to lead to
improved health outcomes and greater patient and physician satisfaction. The benefits
of continuity of care remain controversial, however, and have not been firmly
established for pediatric patients. The objective of this study was to examine whether
continuity of care with a primary care provider is associated with the number of
emergency department (ED) visits in children and adolescents with a diagnosis of
attention-deficit/hyperactivity disorder (ADHD) in British Columbia We analyzed
two years of physician claims records for over 4000 British Columbia children aged 4
to 16 to determine individual continuity of care (COC) scores for each study
participant. Multinomial logistic regression analysis was then applied to determine if a
relationship exists between COC computed during two years and number of ED visits
made during the following year.
Our results showed a weak association between continuity with a primary care
provider and ED use. In multivariate analysis, continuity was associated with a lower
likelihood of making a single ED visit (odds ratio, 0.85; 95% confidence interval, 0.70-
1.05) and is more strongly associated with a lower likelihood of making multiple E D
visits (odds ratio, 0.81; 95% confidence interval, 0.62-1.05). Other variables that were
associated with outcome include: age, socio-economic status, overall number of
general practitioner visits, pediatrician visits, psychiatrist visits, and illness burden.
This study demonstrates that high primary care provider continuity is associated
with lower ED use for children aged 4 to 16 with ADHD in British Columbia. The
results suggest that strategies to improve continuity of primary care provider among
this population may lead to decreased ED utilization and should therefore be
encouraged.
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Extent |
4602739 bytes
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Genre | |
Type | |
File Format |
application/pdf
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Language |
eng
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Date Available |
2009-08-06
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Provider |
Vancouver : University of British Columbia Library
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Rights |
For non-commercial purposes only, such as research, private study and education. Additional conditions apply, see Terms of Use https://open.library.ubc.ca/terms_of_use.
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DOI |
10.14288/1.0090023
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URI | |
Degree | |
Program | |
Affiliation | |
Degree Grantor |
University of British Columbia
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Graduation Date |
2001-11
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Campus | |
Scholarly Level |
Graduate
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Aggregated Source Repository |
DSpace
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Item Media
Item Citations and Data
Rights
For non-commercial purposes only, such as research, private study and education. Additional conditions apply, see Terms of Use https://open.library.ubc.ca/terms_of_use.