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	Institution: STANFORD Univ Med Center  | My Account | E-mail Alerts | Access Rights | Sign In Vol. 9 No. 4, April 2000   Archives  •  Online Features Original Contribution  This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (87)  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in this journal The Effect of Continuity of Care on Emergency Department Use James M. Gill, MD, MPH; Arch G. Mainous III, PhD; Musa Nsereko, BDS, MPH Arch Fam Med. 2000;9:333-338. Objective  To examine whether continuity of care with an individual health care provider is associated with the number of hospital emergency department (ED) visits in a statewide Medicaid population. Design  A cross-sectional study based on a 100% sample of Delaware Medicaid claims for 1 year (July 1, 1993, to June 30, 1994). Continuity with a single provider during the year was computed for each participant. Setting  The state of Delaware. Participants  Continuously enrolled Medicaid clients aged 0 to 64 years who had made at least 3 physician office visits during the study year (N=11,474). Intervention  None. Main Outcome Measures  Likelihood of making a single ED visit or multiple ED visits during the study year. Results  In multivariate analysis, continuity is associated with a significantly lower likelihood of making a single ED visit (odds ratio, 0.82; 95% confidence interval, 0.70-0.95), and is even more strongly associated with a lower likelihood of making multiple ED visits (odds ratio, 0.65; 95% confidence interval, 0.56-0.76). Conclusions  This study demonstrates that high provider continuity is associated with lower ED use for the Medicaid population. This suggests that strategies to improve continuity of care may result in lower ED use and possibly reduced health care costs. Such strategies may be more acceptable than current managed care policies that attempt to control costs by denying access to emergency care. From the Departments of Family and Community Medicine (Dr Gill) and Performance Improvement (Mr Nsereko) Christiana Care Health Services, Wilmington, Del; and the Medical University of South Carolina, Charleston (Dr Mainous). RELATED ARTICLE The Archives of Family Medicine Continuing Medical Education Program Arch Fam Med. 2000;9(4):375-377. FULL TEXT   THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES The Burden of Rotavirus Hospitalizations Among Medicaid and Non-Medicaid Children Younger Than 5 Years Old Ma et al. AJPH 2009;99:S398-S404. ABSTRACT | FULL TEXT   Continuity of Care and Intensive Care Unit Use at the End of Life Sharma et al. Arch Intern Med 2009;169:81-86. 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Arch Pediatr Adolesc Med 2004;158:17-21. ABSTRACT | FULL TEXT   The Many Faces of Access: Reasons for Medically Nonurgent Emergency Department Visits Guttman et al. Journal of Health Politics, Policy and Law 2003;28:1089-1120. ABSTRACT   Familiarity breeds neglect? Unanticipated benefits of discontinuous primary care Broom Fam Pract 2003;20:503-507. ABSTRACT | FULL TEXT   Continuity of Care: Process or Outcome? Christakis Ann Fam Med 2003;1:131-133. FULL TEXT   Defining and Measuring Interpersonal Continuity of Care Saultz Ann Fam Med 2003;1:134-143. ABSTRACT | FULL TEXT   On Being New to an Insurance Plan: Health Care Use Associated With the First Years in a Health Insurance Plan Franks et al. Ann Fam Med 2003;1:156-161. ABSTRACT | FULL TEXT   Impact of Provider Continuity on Quality of Care for Persons With Diabetes Mellitus Gill et al. Ann Fam Med 2003;1:162-170. ABSTRACT | FULL TEXT   Towards a theory of continuity of care Gray et al. JRSM 2003;96:160-166. FULL TEXT   Racial and Ethnic Disparities in the Primary Care Experiences of Children: A Review of the Literature Stevens and Shi Med Care Res Rev 2003;60:3-30. ABSTRACT   Continuity of Care for Children in Foster Care DiGiuseppe and Christakis Pediatrics 2003;111:e208-213. ABSTRACT | FULL TEXT   Emergency Department Use Among the Homeless and Marginally Housed: Results From a Community-Based Study Kushel et al. AJPH 2002;92:778-784. ABSTRACT | FULL TEXT   HOME | CURRENT ISSUE | PAST ISSUES | TOPIC COLLECTIONS | CME | PHYSICIAN JOBS | HELP CONDITIONS OF USE | PRIVACY POLICY | CONTACT US | SITE MAP   © 2000 American Medical Association. All Rights Reserved.