Provider continuity and outcomes of care for persons with schizophrenia

The study examines the relationship of provider continuity to outcomes of care (quality of life, payments for services) for Medicaid beneficiaries with schizophrenia. Data sources included Maryland Medicaid claims and enrollment data and in-person interviews. Measures of provider continuity over the year preceding the interview, calculated from claims for mental health ambulatory visits, were usual provider continuity (UPC - fraction of visits to the most frequently seen provider), sequential continuity (SECON - fraction of sequential visit pairs to the same provider), and continuity of care (COC - distribution of visits across different providers). Higher provider continuity was found to be related to lower costs and to lower likelihood of mental illness hospitalization. Provider continuity was not significantly related to general life satisfaction or to satisfaction with health. Persons with zero or one visit in a year (and for whom provider continuity could not be measured) had more severe depressive symptoms and were more likely to abuse substances but reported comparable satisfaction with health and overall quality of life while incurring lower Medicaid costs.