Evaluation of a patient-reported continuity of care model for older adults

Abstract

Purpose: Although continuity of care (CoC) is a cornerstone of many health policies, there is no theoretically driven model of CoC that incorporates the experiences of older adults. We evaluated such a model in data collected for another purpose. Methods: We used data on 2,620 Medicare beneficiaries who completed all of the necessary components of the 2004 National Health and Health Services Use Questionnaire (NHHSUQ). The NHHSUQ solicited information on usual primary provider, place of care, and the quality and duration of the patient-provider relationship. We used confirmatory factor analysis to evaluate the patient-reported CoC model and examined factorial invariance across sex, race/ethnicity, Medicare plan type, and perceived health status. Results: Our thirteen-item CoC model consisted of longitudinal (care site and provider duration) and interpersonal (instrumental and affective) domains. Although the overall chi-square goodness-of-fit statistic was significant (χ 2 = 1,091.8, df = 57, p