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Research ArticleOriginal Research

The Association of Family Continuity with Infant Health Service Use

Elizabeth C. Clark, John Saultz, David I. Buckley, Rebecca Rdesinski, Bruce Goldberg and James M. Gill
The Journal of the American Board of Family Medicine September 2008, 21 (5) 385-391; DOI: https://doi.org/10.3122/jabfm.2008.05.070040
Elizabeth C. Clark
MD, MPH
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John Saultz
MD
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David I. Buckley
MD, MPH
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Rebecca Rdesinski
MSW
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Bruce Goldberg
MD
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James M. Gill
MD, MPH
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Article Figures & Data

Tables

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    Table 1.

    Demographic Characteristics of Study Sample

    CharacteristicN (%)
    Gender
        Female768 (48.3)
        Male823 (51.7)
    Race
        White1087 (68.3)
        Hispanic312 (19.6)
        African-American103 (6.5)
        Other89 (5.6)
    Mother's age at time of birth (yr)
        <20307 (19.3)
        20–24606 (38.1)
        25–34545 (34.3)
        35+133 (8.4)
    Residence
        Urban1075 (67.6)
        Rural516 (32.4)
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    Table 2.

    Comparison of Outcome Measures by Family Continuity Status*

    Outcome MeasureTotal Population (N = 1591)Continuity (n = 749)No Continuity (n = 842)P
    Continuous (mean [SD])
        Well-child visits4.55 (1.718)4.64 (1.744)4.47 (1.693).045†
        ED visits1.23 (1.783)1.45 (1.934)1.04 (1.614)<.001†
        Hospitalizations0.17 (0.486)0.16 (0.458)0.18 (0.509).528†
    Categorical ([%] n)
        Well-child visits (≥6)31.8 (506)33.5 (251)30.3 (255).168‡
        ED visits (≥1)54.0 (859)60.3 (452)48.3 (407)<.0001‡
        Hospitalizations (≥1)13.4 (213)12.8 (96)13.9 (117).606‡
    • * Hospitalizations does not include birth hospitalization.

    • † P values for continuous variable analyses are from the independent sample t test for well-child visits, which are normally distributed, and from the Mann-Whitney U test for ED visits and hospitalizations, which are not normally distributed.

    • ‡ P values for categorical variable analyses are from the Pearson χ2 test.

    • ED, emergency department.

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    Table 3.

    Multivariate Results*

    Continuity (Relative Risk [95% CI])P
    Count Outcomes†
        Well-child visits1.05 (1.00–1.10).041
        ED visits1.36 (1.18–1.56)<.0001
        Hospitalizations0.85 (0.64–1.14).282
    Categorical Outcomes‡
        Well-child visits (≥6)1.22 (0.98–1.52).070
        ED visits (≥1)1.53 (1.25–1.88)<.0001
        Hospitalizations (≥1)0.87 (0.65–1.17).361
    • * Six different multivariate models were developed, one for each outcome. In this table, only the relative risk for continuity is presented. Each model controlled for the baby's gender, race, county of residence, and the mother's age.

    • † Count outcome multivariate analyses were performed using negative binomial regression.

    • ‡ Categorical outcome multivariate analyses were performed using logistic regression.

    • ED, emergency department; CI, confidence interval.

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The Journal of the American Board of Family Medicine: 21 (5)
The Journal of the American Board of Family Medicine
Vol. 21, Issue 5
September-October 2008
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The Association of Family Continuity with Infant Health Service Use
Elizabeth C. Clark, John Saultz, David I. Buckley, Rebecca Rdesinski, Bruce Goldberg, James M. Gill
The Journal of the American Board of Family Medicine Sep 2008, 21 (5) 385-391; DOI: 10.3122/jabfm.2008.05.070040

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The Association of Family Continuity with Infant Health Service Use
Elizabeth C. Clark, John Saultz, David I. Buckley, Rebecca Rdesinski, Bruce Goldberg, James M. Gill
The Journal of the American Board of Family Medicine Sep 2008, 21 (5) 385-391; DOI: 10.3122/jabfm.2008.05.070040
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