Journal of General Internal Medicine

, Volume 23, Issue 9, pp 1499–1502

Primary Care Physician Visit Continuity: A Comparison of Patient-reported and Administratively Derived Measures

  • Hector P. Rodriguez
  • Richard E. Marshall
  • William H. Rogers
  • Dana Gelb Safran
Brief Report

DOI: 10.1007/s11606-008-0692-z

Cite this article as:
Rodriguez, H.P., Marshall, R.E., Rogers, W.H. et al. J GEN INTERN MED (2008) 23: 1499. doi:10.1007/s11606-008-0692-z



Studies find that primary care physician (PCP) visit continuity is positively associated with care quality. Some of the evidence base, however, relies on patient-reported continuity measures, which may be subject to response bias.


To assess the concordance of patient-reported and administratively derived visit continuity measures.


Random samples of patients (n = 15,126) visiting 1 of 145 PCPs from a physician organization in Massachusetts were surveyed. Respondents reported their experienced visit continuity over the preceding 6 months. Usual Provider Continuity (UPC), an administratively derived measure, was calculated for each respondent. The concordance of patient reports and UPC was examined. Associations with patient-reported physician-patient interaction quality were assessed for both measures.


Patient-reported and administratively derived visit continuity measures were moderately correlated for overall (r = 0.30) and urgent (r = 0.30) measures and modestly correlated for the routine (r = 0.17) measure. Although patient reports and UPC were significantly associated with the physician-patient interaction quality (p < 0.001), the effect size for patient-reports was approximately five times larger than the effect size for UPC.


Studies and quality initiatives seeking to evaluate visit continuity should rely on administratively derived measures whenever possible. Patient-reported measures appear to be subject to biases that can overestimate the relationship between visit continuity and some patient-reported outcomes.


continuity of carequality measurementpatient-reported outcomesphysician-patient communication

Copyright information

© Society of General Internal Medicine 2008

Authors and Affiliations

  • Hector P. Rodriguez
    • 1
  • Richard E. Marshall
    • 2
  • William H. Rogers
    • 3
  • Dana Gelb Safran
    • 3
  1. 1.Department of Health Services, School of Public Health and Community MedicineUniversity of WashingtonSeattleUSA
  2. 2.Harvard Vanguard Medical AssociatesBostonUSA
  3. 3.The Health Institute, Institute for Clinical Research and Health Policy StudiesTufts Medical CenterBostonUSA