Continuity Measure
Our primary predictor variable was an index of COC. Several such indices have been developed.21–23 We opted to use the COC index developed by Bice and Boxerman23 that is derived from Rae and Taylor's index of fragmentation24 and is of the general form:COC=∑j=1s nj2−NN(N−1)where N = total number of visits n = number of visits to providerjs = number of providers
The COC takes on values between 0 and 1. A value of 0 signifies maximum dispersion, which occurs when a different provider is seen for every visit. A value of 1 signifies minimum dispersion, which occurs when the same provider is seen at every visit. To demonstrate the behavior of the COC, several hypothetical patterns each involving 8 visits are shown in Table 1. Note that as the contacts with providers become more dispersed—from all visits with Provider A to every visit with a different provider—the COC moves from 1 to 0. We calculated patients' COC indices based only on visits to primary care pediatricians or family physicians. Visits to specialists or subspecialists were not included in computing the COC index.
Association of lower continuity of care with greater risk of emergency department use and hospitalization in children - PubMed
Lower continuity of primary care is associated with higher risk of ED utilization and hospitalization. Efforts to improve and maintain continuity may be warranted.
pubmed.ncbi.nlm.nih.gov