ArticleHealth services research2016
Are Two Heads Better Than One or Do Too Many Cooks Spoil the Broth? The Trade-Off between Physician Division of Labor and Patient Continuity of Care for Older Adults with Complex Chronic Conditions.
Article in Health services research, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Quality Indicators for High-Need Patients: a Systematic Review.Journal of general internal medicine · 2022Pooled it
- The Contribution of Patient, Primary Care Physician, and Primary Care Clinic Factors to Good Bone Health Care.The Permanente journal · 2021Trial
- Exploring the Intensity and Continuity of Hospital Care for Patients With Long Covid: Evidence From an English Urban Healthcare System.Health expectations : an international journal of public participation in health care and health policy · 2026Observational
- Specialists are central to patient chronic condition care: Medicare ACOs must adapt to this reality.Health affairs scholar · 2025Article
- High-performing primary care clinics across high-need, high-cost Medicare populations.BMJ open quality · 2023Article
- Continuity of care and advanced prostate cancer.Cancer medicine · 2023Article
- Characteristics, utilization, and concentration of outpatient care for dual-eligible Medicare beneficiaries.The American journal of managed care · 2022Article
- Low Rates of Clinician Monitoring for Second Generation Antipsychotic Medications in Community Pediatric Practice.Community mental health journal · 2022Observational
- The Impact of Continuity of Care on Cervical Cancer Screening: How Visit Pattern Affects Guideline Concordance.Journal of cancer education : the official journal of the American Association for Cancer Education · 2022Article
- Comparison of Ambulatory Care Access and Quality for Beneficiaries With Disabilities Covered by Medicare Advantage vs Traditional Medicare Insurance.JAMA health forum · 2022Article
- Impact of New York State's Health Home program on access to care among patients with diabetes.BMJ open diabetes research & care · 2021Article
- National Trends and Outcomes Associated With Presence and Type of Usual Clinician Among Older Adults With Multimorbidity.JAMA network open · 2021Article
- Observational
- Continuity of care and health care cost among community-dwelling older adult veterans living with dementia.Health services research · 2021Article
- Specialized primary care medical home: A positive impact on continuity of care among autistic adults.Autism : the international journal of research and practice · 2021Article
- Patient social risk factors and continuity of care for Medicare beneficiaries.Health services research · 2020Observational
- Continuity of Medication Management among Adults with Schizophrenia and Comorbid Cardiometabolic Conditions.Journal of pharmaceutical health services research : an official journal of the Royal Pharmaceutical Society of Great Britain · 2018Article
- Best of the 2016 AcademyHealth Annual Research Meeting.Health services research · 2016Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo examine the effects of physician division of labor and patient continuity of care (COC) on the care quality and outcomes of older adults with complex chronic conditions. DATA SOURCES/STUDY
settingSeven years (2006-2012) of panel data from the Medicare Current Beneficiary Survey (MCBS). STUDY
designRegression models were used to estimate the effect of the specialty-type of physicians involved in annual patient evaluation and management, as well as patient COC, on simultaneous care processes and following year outcomes. DATA COLLECTION/EXTRACTION
methodsMultiyear cohorts of Medicare beneficiaries with diabetes and/or heart failure were retrospectively identified to create a panel of 15,389 person-year observations. PRINCIPAL
findingsInvolvement of both primary care physicians and disease-relevant specialists is associated with better compliance with process-of-care guidelines, but patients seeing disease-relevant specialists also receive more repeat cardiac imaging (p < .05). Patient COC is associated with less repeat cardiac imaging and compliance with some recommended care processes (p < .05), but the effects are small. Receiving care from a disease-relevant specialist is associated with lower rates of following year functional impairment, institutionalization in long-term care, and ambulatory care sensitive hospitalization (p < .05).
conclusionsAnnual involvement of disease-relevant specialists in the care of beneficiaries with complex chronic conditions leads to more resource use but has a beneficial effect on outcomes.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.