RESEARCH ARTICLE


Association between Continuity of Primary Care and Chronic Conditions among Patients in Guangdong Province, China



Sultana Mubarika Rahman Chowdhury1, Mengping Zhou2, Kuang Li3, Nan Hu1, 4, *
1 Department of Biostatistics, Florida International University Robert Stempel College of Public Health and Social Work, Miami, Florida33199, USA
2 Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
3 Department of Health Administration, Sun Yat-sen University, Guangzhou, China
4 Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City84112, USA


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Creative Commons License
© 2022 Chowdhury et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Biostatistics, Florida International University Robert Stempel College of Public Health and Social Work, Miami, Florida 33199, USA; Tel: +1-305-348-0139; E-mail: nhu@fiu.edu


Abstract

Background:

One important aspect of primary care is the association between continuity with primary care providers (PCPs) and chronic conditions among patients. However, there is a lack of literature to specifically address these issues in countries with large populations, such as China.

Objective:

The goal of this study is to examine the effect of chronic conditions on the continuity of primary care among patients from a cross-sectional survey conducted in Guangdong province, China.

Methods:

Multiple logistic regression was used to estimate the effect of chronic conditions on continuity. Effect modification by residency status (migrants vs. locals) on the relationship between the number of chronic conditions and continuity was also assessed. The intermediate effect of the existing contract between patients and PCPs was also evaluated for examining the relationship between chronic conditions and continuity of primary care.

Results:

Participants with chronic conditions had 2.32 (95% CI: 1.78 - 3.04) times the odds to continue with their PCPs for one year or more. Compared to those without any chronic condition, individuals with one chronic condition had 2.03 (95% CI: 1.49 - 2.75) times, and more than one chronic condition had 3.00 (95% CI: 2.01 - 4.49) times the odds to continue with their PCPs. The residency status of the participants did not modify the effect of the number of chronic conditions on the continuity of primary care. The contract between patients and their PCPs was found to be an intermediate factor for the relationship between chronic conditions and continuity.

Conclusion:

To strengthen the connection between patients with chronic conditions, PCPs may reinforce the relationship between providers and patients, thus ultimately benefitting the patients. The results of this study can serve as a reference for policymakers.

Keywords: Primary care, Chronic conditions, Continuity of primary care, Migrant health, Patient and physician relationship, Primary care contract.