. Author manuscript; available in PMC: 2012 Jul 11.

Published in final edited form as: Arch Intern Med. 2011 Apr 25;171(13):1150–1159. doi: 10.1001/archinternmed.2011.168

Table 6.

Clinical outcomes of advanced access

Source	Continuity of care, practices without AA	Continuity of care, practices with AA	Change in continuity	P value	Urgent Care/ED/hospital use without AA→with AA	Other clinical outcome
Belardi et al., 2004 ²⁶	~75%	>90%	~15%	<.015
Parente et al., 2005 ⁶⁷	69.8%	91.4%	24.1%	<.000
Solberg et al., 2004²⁵, Solberg et al, 2006³⁴, Sperl-Hillen et al., 2008 ³⁵	COC index¹⁹ CHD: 0.66 DM: 0.68 Dep: 0.60	COC index¹⁹ CHD: 0.72 DM: 0.73 Dep: 0.63	CHD: 0.06 DM: 0.05 Dep: 0.03	<.0001 <.0001 <.0001	1 or more visits to urgent care CHD 13.5%→8.6% p<.0001 DM 17.5%→12.4% p<.0001 Dep 31.8%→22.8% p<.0001 1 or more visits to ED^* CHD 51.5%→50.9% p=0.068 DM 14.4%→15.1% p=0.078 Dep 14.9%→16.9% p=0.15 1 or more ED or urgent care visit DM 41%→37.6%, p<.001 1 or more hospitalizations^* CHD 58.4%→57.3% p=0.002 DM 9.5%→9.7% p=0.70 Dep 7.7%→8.9% p=0.13 Mental health ED visit or hospitalization Dep 6.5%→6.3% p=.34	Diabetes quality: A1c <7% 44.4→52.7% p<.001 LDL<100 29.8→38.7% p<.001 Depression quality Continuation of new medication for 180 days 46.2%→50.8% p<.001
Phan et al., 2009 ⁴⁶	UPC²¹ 0.56 MMCI²⁰ 0.49	UPC²¹ 0.54 MMCI²⁰ 0.43	UPC²¹ -0.02 MMCI²⁰ −0.06	0.13 0.001
Bundy et al., 2005 ²⁹	76%	89%	13% (95% CI, −7 to 32)	NS
O’Connor et al., 2006 ⁴³	75%	60%	−15%	NS		On-time immunization rate 74% in AA group 74% in non-AA group
Salisbury et al., 2007 ³³; Pickin et al., 2010⁵¹	COC index¹⁸ 0.43→0.46	COC index¹⁸ 0.43→0.40	Adjusted diff .003 (−0.07 to 0.07)	0.93		Antibiotic prescribing Reduction in monthly prescriptions of 0.9 items/1,000 patients AA relative to controls (95% CI, −2.2 to 0.4, p=0.16)
Meyers et al., 2003 ³⁹	~38%	~45%	~7%	NR
Bennett et al., 2009 ²⁷	64.0%	68.2%	4.2%	NR
Subramanian et al., 2009⁴⁸					ED or urgent care visits OR 0.97 (95% CI 0.92 to 1.02) Hospitalizations OR 0.95 (95% CI 0.81 to 1.11)	Diabetic quality A1c −0.12% (95% CI −0.21 to −0.03) SBP 6.4 (95% CI 5.4 to 7.5) LDL −0.2 (95% CI −2.0 to 1.5)
Radel et al, 2001⁴⁰						Cardiovascular quality LDL<100 52%→75% HTN BP control <140/86 64%→96% Diabetes quality Hgb A1c ≤ 7.5 65.5%→76.6%

Data are from Solberg 2004. Solberg 2006 using same dataset reports 1 or more visits to the ED for depression as 25.6→27.3, p=.13 and 1 or more hospitalizations as 19.9→21.7 p<.05.

AA, advanced access; COC, continuity of care; UPC, Usual Provider Continuity Index; MMCI, Modified, Modified Continuity Index; CHD, coronary heart disease; DM, diabetes; Dep, depression; ED, emergency department; OR, odds ratio; NR, not reported; NS, reported as not significant.