Article Figures & Tables
Figures
- Figure 1:
Incidence rate ratios for use of the emergency department by affiliation with a primary physician (overall and stratified by age) among 311 701 patients who made three or more physician visits during the baseline period. Models adjusted for age, sex, material deprivation, area of residence, number of physician visits and time spent in hospital during baseline. Patients with a specialist or no primary physician are compared, with patients with a family physician acting as the reference group. CI = confidence interval, IRR = incidence rate ratio.
- Figure 2:
Incidence rate ratios for use of the emergency department by continuity of care by a family physician (overall and stratified by number of doctor visits) among 271 990 patients who made three or more visits to physicians during the baseline period, and who have a family physician. Models adjusted for age, sex, material depreivation, area of residence, number of physician visits and time spent in hospital during baseline. Patient with low or medium scores on the Usual Provider Care index are compared, with high scores acting as the reference group. CI = confidence interval, IRR = incidence rate ratios, UPC = usual provider continuity.
- Figure 3:
Incidence rate ratios for use of the emergency department by continuity of care by a specialist (overall and stratified by comorbidity score and number of days spent in hospital) among 27 752 patients who made three or more visits to physicians during the baseline period and who have a specialist as their primary physician. Models adjusted for age, sex, material deprivation, area of residence, number of physician visits and time spent in hospital during baseline. Patients with low or medium scores on the Usual Provider Care index are compared, with patients with high scores acting as the reference group. CI = confidence interval, IRR = incidence rate ratio, UPC = usual provider continuity.
Tables
- Table 1:
Characteristics of the excluded sample (i.e., low users) and the analysis cohort during the two-year baseline and one-year follow-up periods
Characteristic Patients with fewer than 3 visits to a physician during baseline, %
n = 55 614Analysis cohort Total, %
n = 311 701No primary physician, %
n= 11 959Family physician, %
n = 271 990Specialist, %
n = 27 752Age, yr 18–34 40.9 24.8 46.3 22.3 34.1 35–64 54.2 56.8 47.5 58.0 51.8 65–74 3.1 11.1 3.9 11.9 8.7 ≥ 75 1.8 7.3 2.4 7.8 5.5 Sex Male 63.8 41.8 54.7 40.4 46.2 Female 36.2 58.2 45.3 59.6 53.8 Material deprivation percentile 1–50 53.1 55.0 57.0 54.7 56.4 51–100 44.9 43.0 41.1 43.3 41.5 Missing 2.0 2.1 1.9 2.1 2.1 Area of residence Urban 44.7 38.8 31.1 40.3 31.1 Metropolitan 55.3 61.2 68.9 59.7 68.9 Health status, comorbidity score percentile Low, 0–60 76.0 56.5 59.9 55.4 63.8 Medium, 61–80 21.5 24.4 30.9 23.9 24.8 High, 81–100 2.6 19.1 9.2 20.7 11.4 Visits to physicians during baseline, no. 0–2 100.0 — — — — 3–8 — 48.0 91.7 43.1 64.9 9–24 — 43.0 7.5 46.9 30.6 ≥ 25 — 9.0 0.8 10.1 4.6 Time spent in hospital during baseline, d 0 97.4 85.9 93.3 86.3 79.0 1–3 1.1 4.5 2.5 4.2 7.6 ≥ 4 1.5 9.6 4.3 9.5 13.4 Visits to emergency department during baseline, no. 0 70.1 61.7 63.6 61.7 60.6 1 20.0 20.1 20.5 20.1 20.6 2 5.8 8.7 8.7 8.6 9.1 ≥ 3 4.1 9.5 7.3 9.6 9.8 Affiliation with a primary physician Low user 100.0 — — — — None — 5.5 100.0 — — Family physician — 84.1 — 100.0 — Specialist — 10.3 — — 100.0 Usual provider continuity index with a primary physician* Low (< 0.40) — 32.5 — 34.7 15.2 Medium (0.40–0.79) — 51.1 — 49.5 64.1 High (0.80–1.0) — 16.4 — 15.8 20.7 Complete annual examinations, no. 0 — 65.8 — 59.3 — 1 — 25.0 — 29.8 — ≥ 2 — 9.2 — 11.0 — Visits to emergency department during follow-up, no. 0 82.5 76.2 78.0 75.9 77.4 1 12.1 15.0 14.3 15.1 14.4 2 3.4 4.9 4.7 5.0 4.6 ≥ 3 1.9 3.9 3.0 4.0 3.6 ↵* Among participants with a primary physician (n = 299 742).
- Table 2:
Primary care variables predicting use of emergency department, overall and by patient baseline characteristics*
Interaction IRR (95% CI) Overall Affiliation with a primary physician None v. family physician 1.12 (1.07–1.17) None v. specialist 1.08 (1.03–1.14) Specialist v. family physician 1.03 (1.00–1.06) Continuity of care with a family physician† Low v. high 1.00 (0.97–1.03) Medium v. high 1.00 (0.97–1.02) Complete annual examinations with a family physician, no. 0 v. 2 1.23 (1.19–1.27) 1 v. 2 1.10 (1.07–1.14) Continuity of care with a specialist† Low v. high 1.17 (1.07–1.28) Medium v. high 1.10 (1.01–1.18) Age, 18–64 yr Affiliation with a primary physician None v. family physician 1.11 (1.05–1.16) None v. specialist 1.10 (1.04–1.17) Specialist v. family physician 1.00 (0.97–1.04) Age, ≥ 65 yr Affiliation with a primary physician None v. family physician 1.26 (1.18–1.34) None v. specialist 1.11 (1.04–1.19) Specialist v. family physician 1.13 (1.09–1.17) Visits to physicians during baseline, 3–24 Continuity of care with a family physician† Low v. high 0.98 (0.95–1.01) Medium v. high 0.99 (0.96–1.02) Visits to physicians during baseline, ≥ 25 Continuity of care with a family physician† Low v. high 1.17 (1.07–1.28) Medium v. high 1.13 (1.04–1.24) No or low comorbidity score‡ Continuity of care with a specialist† Low v. high 1.10 (0.96–1.27) Medium v. high 1.10 (1.00–1.22) Medium comorbidity score‡ Continuity of care with a specialist† Low v. high 1.48 (1.22–1.79) Medium v. high 1.28 (1.08–1.51) High comorbidity score‡ Continuity of care with a specialist† Low v. high 0.98 (0.80–1.21) Medium v. high 0.93 (0.77–1.13) Time spent in hospital, 0 d Continuity of care with a specialist† Low v. high 1.11 (0.99–1.25) Medium v. high 1.08 (0.98–1.18) Time spent in hospital, 1–3 d Continuity of care with a specialist† Low v. high 1.75 (1.33–2.30) Medium v. high 1.31 (1.05–1.65) Time spent in hospital, ≥ 4 d Continuity of care with a specialist† Low v. high 1.11 (0.90–1.37) Medium v. high 1.05 (0.87–1.27)
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