• Tara Kiran, Michael E Green, Li Bai, Lidija Latifovic, Shahriar Khan, Alex Kopp, Eliot Frymire, and Richard H Glazier.
• From Department of Family and Community Medicine, St. Michael's Hospital, Toronto, Ontario, Canada; Department of Family and Community Medicine, University of Toronto, Ontario, Canada (TK, RHG); MAP Centre for Urban Health Solutions, St. Michael's Hospital, Unity Health, Toronto, Ontario, Canada (TK, LL, RHG); Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada (TK, RHG); ICES Central, Toronto, Ontario, Canada (TK, LB, AK, RHG); ICES Queen's, Kingston, Ontario, Canada (MEG, SK, EF); Health Services and Policy Research Institute, Queen's University, Kingston, Ontario, Canada (MEG, SK, EF); Department of Family Medicine, Queen's University, Kingston, Ontario, Canada (MEG); Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada (LL, RHG).
• J Am Board Fam Med. 2023 Feb 8; 36 (1): 130141130-141.

PurposeContinuity is a core component of primary care and known to differ by patient characteristics. It is unclear how primary care physician payment and organization are associated with continuity.MethodsWe analyzed administrative data from 7,110,036 individuals aged 16+ in Ontario, Canada who were enrolled to a physician and made at least 2 visits between October 1, 2017 and September 30, 2019. Continuity with physician and practice group was quantified using the usual provider of care index. We used log-binomial regression to assess the relationship between enrollment model and continuity adjusting for patient characteristics.ResultsMean physician and group continuity were 67.3% and 73.8%, respectively, for patients enrolled in enhanced fee-for-service, 70.7% and 76.2% for nonteam capitation, and 70.6% and 78.7% for team-based capitation. These differences were attenuated in regression models for physician-level continuity and group-level continuity. Older age was the most notable factor associated with continuity. Compared with those 16 to 34, those 80 and older had 1.45 times higher continuity with their physician.ConclusionOur results suggest that continuity does not differ substantially by physician payment or organizational model among primary care patients who are formally enrolled with a physician in a setting with universal health insurance.© Copyright by the American Board of Family Medicine.

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