The following is a summary of “Measuring the Value Functions of Primary Care: Physician-Level Continuity of Care Quality Measure” published in the November 2022 issue of Family Medicine by Dai et al.
Though continuity of care (CoC) is a cornerstone of the clinician-patient relationship, more needs to be done to operationalize it as a clinical quality indicator. The Primary Care CoC clinical quality measure was created by the American Board of Family Medicine as part of the Measures That Matter to Primary Care project. The Bice-Boxerman Continuity of Care Index was computed for each patient using claims data from the previous 12 months from Optum Clinformatics Data Mart, and then the results were summed to get an overall CoC score for each practitioner. A physician’s performance is measured by the percentage of patients whose Bice-Boxerman Index is at least ≥0.7 (70%). There were 2 approaches in which we examined validity.
To begin, researchers looked at the reliability of utilizing 0.7 as a cutoff for patient CoC within the Optum claims database to ensure accuracy in reflecting continuity at the patient level. Second, investigators looked at the correlation between the physician’s CoC measure and patient outcomes to determine if it is reliable. The signal-to-noise ratio analysis to determine dependability. The primary care physicians in the sample had a mean performance of 27.6% on the measure, with scores ranging from 0% to 100% (n=555,213 primary care physicians).
A greater sense of community was linked to reduced use of medical services. There was sufficient evidence that the instrument was valid and reliable. Patient choice, lower costs, and better health are all linked to continuity of care. For primary care payment and accountability, the CoC clinical quality measure is valid and reliable. Care continuity is essential and works in tandem with access to care; therefore, prioritizing this indicator may influence physician and health system behavior to promote continuity better.