Continuity of Care in Infancy and Early Childhood Health Outcomes

In Pediatrics, Elizabeth Enlow and colleagues, including Scott Lorch, assess the relationship between provider continuity in infancy, and use of both urgent and preventative health services. Continuity of care is a key aspect of the patient-centered medical home and has been shown to improve pediatric outcomes. The authors hypothesize that increased provider continuity in infancy decreases urgent health care use and increases preventative services use in early childhood. They measured continuity across all primary care encounters during the first year of life for 17,773 infants from birth through 3 years. Health care utilization and preventative care outcomes were measured from ages 1 to 3 years, and confounders such as chronic conditions were addressed using statistical models. The authors find that lower continuity is associated with more ambulatory care-sensitive hospitalizations, ambulatory sick visits, and lower odds of lead screening. These associations were stronger for children with chronic conditions. Continuity measured during well visits was not associated with outcomes. The group concludes that continuity may improve care quality and prevent high-cost health encounters, especially for children with chronic conditions.