Evidence map›Paper›PMID 32900763›Full record

ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2020

Primary care of mothers and infants by the same or different physicians: a population-based cohort study.

Natasha R Saunders, Joel G Ray, Christina Diong, Jun Guan, Eyal Cohen

Open access · goldAbstract read
In one paragraph

Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.8field-weighted citation impact, top 19% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 7 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Natasha R SaundersThe Hospital for Sick Children (Saunders, Cohen); Department of Pediatrics (Saunders, Cohen), University of Toronto, Toronto, Ont.; ICES Central (Saunders, Ray, Diong, Guan, Cohen); Keenan Research Centre for Biomedical Science of the Li Ka Shing Knowledge Institute (Ray) and Department of Obstetrics and Gynecology (Ray), St. Michael's Hospital, Toronto, Ont. Natasha.saunders@sickkids.ca.
Joel G RayThe Hospital for Sick Children (Saunders, Cohen); Department of Pediatrics (Saunders, Cohen), University of Toronto, Toronto, Ont.; ICES Central (Saunders, Ray, Diong, Guan, Cohen); Keenan Research Centre for Biomedical Science of the Li Ka Shing Knowledge Institute (Ray) and Department of Obstetrics and Gynecology (Ray), St. Michael's Hospital, Toronto, Ont.
Christina DiongThe Hospital for Sick Children (Saunders, Cohen); Department of Pediatrics (Saunders, Cohen), University of Toronto, Toronto, Ont.; ICES Central (Saunders, Ray, Diong, Guan, Cohen); Keenan Research Centre for Biomedical Science of the Li Ka Shing Knowledge Institute (Ray) and Department of Obstetrics and Gynecology (Ray), St. Michael's Hospital, Toronto, Ont.
Jun GuanThe Hospital for Sick Children (Saunders, Cohen); Department of Pediatrics (Saunders, Cohen), University of Toronto, Toronto, Ont.; ICES Central (Saunders, Ray, Diong, Guan, Cohen); Keenan Research Centre for Biomedical Science of the Li Ka Shing Knowledge Institute (Ray) and Department of Obstetrics and Gynecology (Ray), St. Michael's Hospital, Toronto, Ont.
Eyal CohenThe Hospital for Sick Children (Saunders, Cohen); Department of Pediatrics (Saunders, Cohen), University of Toronto, Toronto, Ont.; ICES Central (Saunders, Ray, Diong, Guan, Cohen); Keenan Research Centre for Biomedical Science of the Li Ka Shing Knowledge Institute (Ray) and Department of Obstetrics and Gynecology (Ray), St. Michael's Hospital, Toronto, Ont.
Hospital for Sick Children · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDifferent primary care delivery models exist for mothers and their infants. We examined whether primary care system performance measures differed when mother-infant dyads received primary care from the same or different providers.

methodsWe conducted a population-based cohort study using Ontario health administrative data from 2004 to 2016. We included primiparous women and their singleton term infants and classified the primary care practitioners who provided the majority of care to the infant and the mother as concordant (same family physician for both; reference group), discordant (a different family physician for each) or pediatrician (pediatrician for the child, family physician for the mother). The primary outcome was nonobstetric maternal hospital admissions between 42 days and 2 years after delivery.

resultsAmong 481 721 mother-child pairs, 239 033 (49.6%) received concordant care, 114 006 (23.7%) received discordant care, and 128 682 (26.7%) received pediatrician care. Mothers in the pediatrician group were older and had greater comorbidity. Relative to concordant care, maternal nonobstetric hospital admissions occurred similarly under discordant care (adjusted odds ratio [OR] 1.00, 95% confidence interval [CI] 0.96-1.04) and in the pediatrician group (adjusted OR 0.99, 95% CI 0.95-1.02). Maternal deaths were similar under discordant care (adjusted OR 1.00, 95% CI 0.62-1.63) but lower in the pediatrician group (adjusted OR 0.55, 95% CI 0.34-0.89). Maternal primary care visits were lower in both the discordant group (adjusted relative risk [RR] 0.68, 95% CI 0.68-0.69) and the pediatrician group (adjusted RR 0.75, 95% CI 0.75-0.76). Healthy children were more likely to miss the enhanced 18-month well-baby visit under discordant care (adjusted OR 1.06, 95% CI 1.03-1.09) but less likely to miss this visit under pediatrician care (adjusted OR 0.47, 95% CI 0.46-0.49).

interpretationConcordant care provided to a new mother and her infant by the same family physician was not associated with better primary care health system performance. The reason that pediatric primary care is associated with better maternal and child outcomes remains to be determined.

Indexed as

Child Health ServicesDelivery of Health CareFemaleHumansInfantInfant, NewbornMaternal Health ServicesOntarioPrimary Health Care

Identifiers

PMID32900763
PMCPMC7504886
OpenAlexW3083701451

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.