Factors Associated With Resident Continuity in Ambulatory Training Practices

BACKGROUND: Continuity of care is a critical element of residents' educational experience in primary care programs. OBJECTIVE: We examined how continuity in resident practices compares to nonteaching practices, identified factors associated with increased continuity, and explored the association between continuity and quality measures. METHODS: We analyzed 117 235 patient visits to 4 resident practices (26 resident teams in internal medicine, pediatrics, family medicine, and medicine-pediatrics) and 270 242 visits to nonteaching community practices between July 2013 and May 2014. We defined continuity from both clinician and patient perspectives, and used logistic regression models to examine the influence of factors on continuity while controlling for postgraduate year, patient age, gender, race, and insurance. RESULTS: < .001 for all). CONCLUSIONS: Increased clinical faculty time, scheduling protocols, and absence of advanced practice providers were most strongly associated with increasing continuity. Increased continuity was associated with improved quality measures.