Effect of Number of Clinics and Panel Size on Patient Continuity for Medical Residents

Abstract

Patient continuity for residents significantly increased with increasing numbers of clinics and decreasing panel size and was significantly influenced by the attending physician.

Clinic Design and Continuity in Internal Medicine Resident Clinics: Findings of the Educational Innovations Project Ambulatory Collaborative

“…These findings describing associations between panel size, number of clinics, and UPC are consistent with prior literature. 9 PHY measures continuity from a different perspective. This measure reflects the percentage of time that residents see their own patients and has been suggested as the most appropriate measure for continuity when evaluating resident outpatient educational experiences.…”

“…Previous studies have demonstrated that clinic time and frequency, as well as patient panel size, affect continuity. [9][10][11] Several structural models have been described and evaluated by internal medicine (IM) residencies throughout the United States. [12][13][14][15][16] Reports from single institutions with innovative education models show conflicting results in patient-provider continuity.…”

Factors Associated With Resident Continuity in Ambulatory Training Practices

“…6,8 Despite its importance, studies documenting resident continuity with patients generally illustrate disappointing findings. [18][19][20][21] One study found that pediatrics patients assigned to a resident physician saw their primary physician at only 25% of their visits. 22 Although past studies have demonstrated varied levels of continuity in resident teaching practices, factors that may improve continuity have not been evaluated.…”

A Primary Care Panel Size of 2500 Is neither Accurate nor Reasonable

“…13 By contrast, reducing the size of a PCP's panel has been shown to result in shorter patient wait times for empaneled appointments, longer visits, 14 and enhanced overall continuity of care. 15 Although these improvements lead to higher overall patient and physician satisfaction, 16 smaller panels may cause difficulties in finding a PCP. Continuity of care has been associated with improved preventive care, lower costs, and an improved experience for patients and physicians.…”