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Full text release has been delayed at the author's request until August 05, 2025

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Racial inequities in continuity of care at pediatric academic primary care clinics

Jones, Margaret
http://rave.ohiolink.edu/etdc/view?acc_num=ucin1692287756141253

Abstract Details

2023, MS, University of Cincinnati, Medicine: Clinical and Translational Research.
Objective: We assessed for inequities in continuity of care, using the Usual Provider Continuity Index (UPC – the proportion of visits with the provider the patient saw most frequently out of all visits), in a set of large pediatric academic clinics. Methods: We conducted a retrospective cohort study. Patients 12-24 months seen at 3 pediatric academic primary care clinics for any visit October 1-31, 2021 were included. We then reviewed continuity for these patients in the preceding 12 months. Outcomes included each patient’s UPC for all visits, and a modified UPC for well child checks only (UPC Well). Covariates included race, ethnicity, insurance, clinic site, age, sex, care management, or seeing a social worker. We evaluated for differences in outcomes using bivariate analyses and multivariable regression models. Results: Our cohort included 356 patients (74% Black, 5% Hispanic, 85% Medicaid, 52% female, median age 15.8 months). The median UPC was 0.33 and median UPC Well was 0.40. Black patients had significantly lower median values for UPC (0.33 Black vs 0.40 non-Black, p<0.0001) and UPC Well (0.33 Black vs 0.50 non-Black, p<0.0001). There were similar inequities in continuity rates by insurance and clinic site. In multivariable models, clinic site was the only variable significantly associated with continuity. Conclusions: Clinic sites serving higher percentages of Black patients had lower rates of continuity. We believe structural racism contributes to these inequities. This analytic approach can be used to inform family-engaged, co-produced improvements in clinic processes, and to address structural factors influencing likelihood of continuity.
Patrick Ryan, Ph.D. (Committee Chair)
Shelley Ehrlich, M.D. (Committee Member)
Andrew Beck, M.D. (Committee Member)
18 p.
Medicine
Racial inequities; Health equity; Continuity of care; Racism; Primary care

Recommended Citations

Citations

  • Jones, M. (2023). Racial inequities in continuity of care at pediatric academic primary care clinics [Master's thesis, University of Cincinnati]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1692287756141253

    APA Style (7th edition)

  • Jones, Margaret. Racial inequities in continuity of care at pediatric academic primary care clinics. 2023. University of Cincinnati, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=ucin1692287756141253.

    MLA Style (8th edition)

  • Jones, Margaret. "Racial inequities in continuity of care at pediatric academic primary care clinics." Master's thesis, University of Cincinnati, 2023. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1692287756141253

    Chicago Manual of Style (17th edition)

ucin1692287756141253
© 2023, all rights reserved.
This open access ETD is published by University of Cincinnati and OhioLINK.