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BMC Primary Care
Published in: BMC Primary Care 1/2022

Open Access 01-12-2022 | Bronchial Asthma | Research

Are primary care and continuity of care associated with asthma-related acute outcomes amongst children? A retrospective population-based study

Authors: Sarah Cooper, Elham Rahme, Sze Man Tse, Roland Grad, Marc Dorais, Patricia Li

Published in: BMC Primary Care | Issue 1/2022

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Abstract

Background

Having a primary care provider and a continuous relationship may be important for asthma outcomes. In this study, we sought to determine the association between 1) having a usual provider of primary care (UPC) and asthma-related emergency department (ED) visits and hospitalization in Québec children with asthma and 2) UPC continuity of care and asthma outcomes.

Methods

Population-based retrospective cohort study using Québec provincial health administrative data, including children 2-16 years old with asthma (N = 39, 341). Exposures and outcomes were measured from 2010-2011 and 2012-2013, respectively. Primary exposure was UPC stratified by the main primary care models in Quebec (team-based Family Medicine Groups, family physicians not in Family Medicine Groups, pediatricians, or no assigned UPC). For those with an assigned UPC the secondary exposure was continuity of care, measured by the UPC Index (high, medium, low). Four multivariate logistic regression models examined associations between exposures and outcomes (ED visits and hospitalizations).

Results

Overall, 17.4% of children had no assigned UPC. Compared to no assigned UPC, having a UPC was associated with decreased asthma-related ED visits (pediatrician Odds Ratio (OR): 0.80, 95% Confidence Interval (CI) [0.73, 0.88]; Family Medicine Groups OR: 0.84, 95% CI [0.75,0.93]; non-Family Medicine Groups OR: 0.92, 95% CI [0.83, 1.02]) and hospital admissions (pediatrician OR: 0.66, 95% CI [0.58, 0.75]; Family Medicine Groups OR: 0.82, 95% CI [0.72, 0.93]; non-Family Medicine Groups OR: 0.76, 95% CI [0.67, 0.87]). Children followed by a pediatrician were more likely to have high continuity of care. Continuity of care was not significantly associated with asthma-related ED visits. Compared to low continuity, medium and high continuity of care decreased asthma-related hospital admissions, but none of these associations were significant.

Conclusion

Having a UPC was associated with reduced asthma-related ED visits and hospital admissions. However, continuity of care was not significantly associated with outcomes. The current study provides ongoing evidence for the importance of primary care in children with asthma.
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Metadata
Title
Are primary care and continuity of care associated with asthma-related acute outcomes amongst children? A retrospective population-based study
Authors
Sarah Cooper
Elham Rahme
Sze Man Tse
Roland Grad
Marc Dorais
Patricia Li
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2022
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/s12875-021-01605-7

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