Children with a Regular Source of Care are Less Likely to Be Hospitalized, Study Says

Children who visit the same doctor regularly are less likely to be hospitalized or visit the emergency room than those who lack a regular source of care, according to a study in this month's issue of Pediatrics. Researchers at the University of Washington's Child Health Institute examined medical records of children enrolled in the Group Health Cooperative, a Washington state consumer-governed health care organization, from 1993 to 1998. Researchers found that children who "seldom or never" visited the same doctor were 60% more likely to visit the emergency room and 54% more likely to be hospitalized than those with a regular source of care, and children who had "only a moderate continuity of care" were 28% more likely to visit the emergency room and 22% more likely to be hospitalized than those with consistent care. Children with chronic diseases were most affected by switching doctors, the researchers found. According to the study, children with asthma who did not visit the same doctor on a regular basis were 80% more likely to be hospitalized. In addition, Medicaid patients were four times more likely to be hospitalized if they did not maintain the same doctor. Dr. Dimitri Christakis, director of the study and associate director of the UW Child Health Institute, said, "There needs to be regular contact with the same physician. ... Unfortunately, the number of obstacles to establishing ... consistent relationships may be increasing in today's changing health care environment."

Understanding the Problem
Researchers offered several "plausible explanations" for their findings, including the following:

• According to previous research, the better patients know their physicians, the more likely they are to take medications as directed.
• When physicians know their patients well, they are more likely to "understand their psychological state and home environment," which helps them determine whether the child can be treated at home, rather than in the hospital, in certain circumstances.
• If parents are familiar with their child's physician, they are less likely to bring their child to the emergency room for a non-emergent problem, and are more likely to wait "a day or so" to see the child's regular doctor.