Canadian Journal of Public Health

, Volume 92, Issue 4, pp 299–303 | Cite as

Characteristics of Patients with a Regular Source of Care

  • Verena H. MenecEmail author
  • Noralou P. Roos
  • Charlyn Black
  • Bogdan Bogdanovic


This study was designed to describe patient characteristics associated with having a regular source of care among all patients who received care from large urban clinics in Manitoba over a three-year period (N = 298,222). Using administrative data, patients were classified as having a regular source of care if they made 75% or more of their total ambulatory visits to the same clinic. Overall, 44.2% of patients had a regular source of care. A logistic regression showed that children and adults aged 45 and older were more likely to have a regular source of care than patients aged 18–44. Moreover, patients with a regular source of care tended to live in more affluent neighbourhoods and were healthier than individuals with no regular source of care. Systemic changes might be needed to enhance continuity of care (e.g., mechanisms to enhance access) among vulnerable segments of the population like the poor.


L’étude compare les caractéristiques des patients recevant des soins d’une source régulière et celles de tous les patients soignés dans de grandes cliniques urbaines du Manitoba sur une période de trois ans (n=298 222). À l’aide de données administratives, nous avons classé parmi les patients ayant une source de soins régulière ceux qui s’étaient rendus dans la même clinique pour au moins 75 % de leurs visites ambulatoires. Dans l’ensemble, 44,2 % des patients avaient une source de soins régulière. L’analyse de régression logistique montre que les enfants et les adultes de 45 ans et plus étaient plus susceptibles d’avoir une source de soins régulière que ceux de 18 à 44 ans. En outre, ils avaient davantage tendance à vivre dans des quartiers aisés et étaient en meilleure santé que ceux qui n’avaient pas de source de soins régulière. Il faudrait peut-être apporter des changements systémiques pour améliorer la continuité des soins (p. ex., des mécanismes facilitant l’accès) chez les segments vulnérables de la population, comme les pauvres.


  1. 1.
    Dietrich AJ, Marton KI. Does continuous care from a physician make a difference? J Fam Pract 1982;15:929–37.PubMedGoogle Scholar
  2. 2.
    Hanson MF. Continuity of care in family practice. J Fam Pract 1975;2:439–444.Google Scholar
  3. 3.
    Starfield B. Primary Care: Balancing Health Needs, Service, and Technology. New York: Oxford University Press, 1998.Google Scholar
  4. 4.
    Gill JM. Can hospitalizations be avoided by having a regular source of care? Fam Med 1997;29:166–71.PubMedGoogle Scholar
  5. 5.
    Mainous AG, Gill JM. The importance of continuity of care in the likelihood of future hospital-ization: Is site of care equivalent to a primary clinician? Am J Public Health 1998;88:1539–1541.CrossRefGoogle Scholar
  6. 6.
    Lambrew JM, DeFriese GH, Carey TS, et al. The effects of having a regular physician on access to primary care. Med Care 1996;34:138–51.CrossRefGoogle Scholar
  7. 7.
    Roos NP, Carriere KC, Friesen D. Factors influencing the frequency of visits by hypertensive patients to primary care physicians in Winnipeg. CMAJ 1998;159:777–83.PubMedPubMedCentralGoogle Scholar
  8. 8.
    Mandelblatt JS, Gold K, O’Malley AS, et al. Breast and cervix cancer screening among multiethnic women: Role of age, health and source of care. Prev Med 1999;28:418–25.CrossRefGoogle Scholar
  9. 9.
    Bindman AB, Brumback K, Osmond D, et al. Primary care and receipt of preventive services. J Gen Intern Med 1996;11:269–76.CrossRefGoogle Scholar
  10. 10.
    Ettner SL. The timing of preventive services for women and children: The effect of having a usual source of care. Am J Public Health 1996;86:1748–54.CrossRefGoogle Scholar
  11. 11.
    O’Malley AS, Mandelblatt J, Gold K, et al. Continuity of care and the use of breast and cervical cancer screening services in a multiethnic community. Arch Intern Med 1997;157:1462–70.CrossRefGoogle Scholar
  12. 12.
    Hayward RA, Bernard AM, Freeman HE, Corey CR. Regular source of ambulatory care and access to health services. Am J Public Health 1991;81:434–38.CrossRefGoogle Scholar
  13. 13.
    Eisen SA, Waterman B, Skinner CS, et al. Sociodemographic and health status characteristics with prostate cancer screening in a national cohort of middle-aged male veterans. Urology 1999;53:516–22.CrossRefGoogle Scholar
  14. 14.
    Mark TI, Paramore LC. Pneumococcal pneumonia and influenza vaccination: Access to and use by US Hispanic Medicare beneficiaries. Am J Public Health 1996;86:1545–50.CrossRefGoogle Scholar
  15. 15.
    O’Connor PJ, Desai J, Rush W, et al. Is having a regular provider of diabetes care related to intensity of care and glycemic control? J Fam Pract 1998;47:290–97.PubMedGoogle Scholar
  16. 16.
    Starfield B. Continuous confusion? Am J Public Health 1980;70:117–19.CrossRefGoogle Scholar
  17. 17.
    Steinwachs DM. Measuring provider continuity in ambulatory care: An assessment of alternative approaches. Med Care 1979;17:551–65.CrossRefGoogle Scholar
  18. 18.
    Rogers J, Curtis P. The concept and measurement of continuity in primary care. Am J Public Health 1980;70:122–27.CrossRefGoogle Scholar
  19. 19.
    Freeman G, Hjortdahl P. What future for continuity of care in general practice? BMJ 1997;314:1870–73.CrossRefGoogle Scholar
  20. 20.
    Mustard CA, Mayer T, Black C, Postl B. Continuity of pediatric ambulatory care in a universally insured population. Pediatrics 1996;98:1028–34.PubMedGoogle Scholar
  21. 21.
    Rask KJ, Williams MV, Parker RM, McNagny SE. Obstacles predicting lack of regular provider and delays in seeking care for patients at an urban public hospital. JAMA 1994;271:1931–33.CrossRefGoogle Scholar
  22. 22.
    Newacheck PW, Stoddard JJ, Hughes DC, Pearl M. Health insurance and access to primary care for children. N Engl J Med 1998;338:513–19.CrossRefGoogle Scholar
  23. 23.
    Forrest CB, Starfield B. Entry into primary care and continuity: The effects of access. Am J Public Health 1998;88:1330–36.CrossRefGoogle Scholar
  24. 24.
    Zuvekas SH, Weinick RM. Changes in access to care 1977–1996: The role of health insurance. Health Serv Res 1999;34:271–79.PubMedPubMedCentralGoogle Scholar
  25. 25.
    Merzel C. Gender differences in health care access indicators in an urban, low-income community. Am J Public Health 2000;90:909–16.CrossRefGoogle Scholar
  26. 26.
    Hemingway H, Saunders D, Parsons L. Social class, spoken language and patterns of care as determinants of continuity of carer in maternity services in east London. J Public Health Med 1997;19:156–61.CrossRefGoogle Scholar
  27. 27.
    Weiss LJ, Blustein J. Faithful patients: The effect of long-term physician-patient relationships on the costs and use of health care by older Americans. Am J Public Health 1996;86:1742–47.CrossRefGoogle Scholar
  28. 28.
    Pilotto LS, McCallum J, Raymond C, et al. Sequential continuity of care by general practitioners: Which patients change doctor? MJA 1996;164:463–66.PubMedGoogle Scholar
  29. 29.
    Veale BM, McCallum J, Saltman DC, et al. Consumer use of multiple general practitioners: An Australian epidemiological study. Fam Pract 1995;12:303–8.CrossRefGoogle Scholar
  30. 30.
    Advisory Committee on Health Services. A Model for the Reorganization of Primary Care and the Introduction of Population-based Funding (Kilshaw Report). Victoria: Queen’s Printer for British Columbia, 1995.Google Scholar
  31. 31.
    Menec VH, Black C, Roos NP, et al. Defining Practice Populations for Primary Care: Methods and Issues. Winnipeg: Manitoba Centre for Health Policy and Evaluation, 1999. Scholar
  32. 32.
    Rosenblatt RA, Hart G, Baldwin LM, et al. The generalist role of specialty physicians: Is there a hidden system of primary care? JAMA 1998;279:1364–70.CrossRefGoogle Scholar
  33. 33.
    Starfield B, Weiner J, Mumford L, Steinwachs D. Ambulatory care groups: A categorization for research and management. Health Serv Res 1991;26:53–74.PubMedPubMedCentralGoogle Scholar
  34. 34.
    Weiner J, Dobson A, Maxwell S, et al. Risk-adjusted Medicare capitation rates using ambulatory and inpatient diagnoses. Health Care Financ Rev 1996;17:77–99.PubMedPubMedCentralGoogle Scholar
  35. 35.
    Weiner J, Starfield B, Steinwachs D, Mumford L. Development and application of a population-oriented measure of ambulatory care case-mix. Med Care 1991;29:452–72.CrossRefGoogle Scholar
  36. 36.
    Powe NR, Weiner J, Starfield B, et al. Systemwide performance in a Medicaid program: Profiling the care of patients with chronic illness. Med Care 1998;34:798–810.CrossRefGoogle Scholar
  37. 37.
    Weiner J, Starfield B, Lieberman RN. Johns Hopkins Ambulatory Care Groups (ACGs): A case-mix system for UR, QA, and capitation adjustment. HMO Post 1992;6:13–19.Google Scholar
  38. 38.
    Reid R, MacWilliam L, Roos NP, et al. Measuring Morbidity in Populations: Performance of the Johns Hopkins Adjusted Clinical Group (ACG) Case-mix Adjustment System in Manitoba. Winnipeg: Manitoba Centre for Health Policy and Evaluation, 1999.Google Scholar

Copyright information

© The Canadian Public Health Association 2001

Authors and Affiliations

  • Verena H. Menec
    • 1
    Email author
  • Noralou P. Roos
    • 1
  • Charlyn Black
    • 1
  • Bogdan Bogdanovic
    • 1
  1. 1.Department of Community Health Sciences and Manitoba Centre for Health Policy and EvaluationUniversity of ManitobaWinnipegCanada

Personalised recommendations