Keywords

continuity of care, costs of care, family physicians, general internists, primary care, resource use, specialist care

Authors

1. Starfield, Barbara MD, MPH
2. Chang, Hsien-Yen PhD
3. Lemke, Klaus W. PhD
4. Weiner, Jonathan P. Dr PH

Abstract

Approximately 7 of 10 (and 95% of the elderly) people in US health plans see one or more specialists in a year. Controlling for extent of morbidity, discontinuity of primary care physician visits is associated with seeing more different specialists. Having a general internist as the primary care physician is associated with more different specialists seen. Controlling for differences in the degree of morbidity, receiving care from multiple specialists is associated with higher costs, more procedures, and more medications, independent of the number of visits and age of the patient.