Questions and Sources	Component of Continuitya	Reliability
Primary Care Assessment Survey22
Q1: Doctor’s knowledge of your entire medical history. Response 1 = very poor to 6 = excellent (relational continuity)	2 and 1
Q2: Doctor’s knowledge of your responsibilities at work or home. Response 1 = very poor to 6 = excellent (relational continuity)	2 and 1
Q3: Doctor’s knowledge of what worries you most about your health. Response 1 = very poor to 6 = excellent (relational continuity)	2 and 1
Q4: If you were unconscious or in a coma, your doctor would know what you would want done for you. Response 1 = strongly disagree to 5 = strongly agree (relational continuity)	2 and 1
Relational continuity: sum(Q1-Q4)/23*10	2 and 1	0.83
Q5: Thoroughness of your doctor’s questions about your symptoms and how you are feeling. Response 1 = very poor to 6 = excellent (interpersonal communication)	2
Q6: Attention your doctor gives to what you have to say. Response 1 = very poor to 6 = excellent (interspersonal communication)	2
Q7: Doctor’s explanations of your health problems or the treatments that you need. Response 1 = very poor to 6 = excellent (interpersonal communication)	2
Q8: Doctor’s instructions about symptoms to report and when to seek further care. Response 1 = very poor to 6 = excellent (interpersonal communication)	2
Q9: Doctor’s advice and help in making decisions about your care. Response 1 = very poor to 6 = excellent (interpersonal communication)	2
Interpersonal communication: sum(Q5-Q9)/30*10	2	0.95
Questions adapted from the Primary Care Assessment Survey22	2
Are there other doctors or nurses who work in your doctor’s office, who play an important role in your care? If yes, thinking about these other doctors or nurses who play an important role in your care, how would you rate the following: Response 1 = very poor to 6 = excellent
Q10: Their knowledge of you as a person (your values and beliefs)
Q11: Their knowledge about your medical history and your health	2
Q12: The quality of care they provide	3
Q13: The coordination between them and your doctor	3
Q14: Their explanations of your health problems or treatments that you need	2 and 3
Q15: How much your regular doctor knows about the care you receive from these other doctors or nurses (for example: visits that you make, treatments recommended). Response 1 = everything to 5 = nothing	4 (inverted)
Coordination within the clinic: sum(Q10–Q14) + (6-Q15)/35*10		0.79
Questions selected from 6 questions in Primary Care Assessment Tool23 (coordination)	3
The following questions refer to the links between your doctor and the last specialist or education center that you were referred to for 1 of the 2 problems targeted by this study (diabetes, cardiovascular disease).
Q16: Did your doctor discuss with you different places you could have gone to get help with that problem? Response 1 = certainly not to 4 = certainly
Q17: Did your doctor write down any information for the specialist about the reason for the visit? Response 1 = certainly not to 4 = certainly	3
Q18: Did your doctor or someone working with your doctor help you make an appointment for that visit? Response 1 = certainly not to 4 = certainly	3
Q19: After you saw the specialist, did you doctor speak to you about what happened during the visit? Response 1 = certainly not to 4 = certainly	3
Coordination with specialists: sum(Q16–Q19)/16*10		0.80
Questions selected from the VA National Outpatient Customer Satisfaction Survey (VANOCSS)24
Q20: Were the providers who cared for you always familiar with your most recent medical history? Response: always, sometimes, no	3 (inverted)
If there were tests in the last few months	3
Q21: Were there times when one of your providers did not know about tests you had or their results? Response: always, sometimes, no
If there were changes in the last few months	3
Q22: Were there times when one of your providers did not know about changes in your treatment that another provider recommended? Response: always, sometimes, no
Q23: Were there times when you were confused because different providers told you different things? Response: always, sometimes, no	3
Q24: Did you always know what the next step in your care would be? Response: always, sometimes, no	3 (inverted)
Q25: Did you know who to ask when you had questions about your health care? Response: always, sometimes, no	3 (inverted)
Overall coordination: ([4-Q20] + sum[Q21-Q2] + [4-Q24] + [4-Q25])/18*10		0.68
Combined continuity score		0.92

^aComponents of continuity¹²:

1. Longitudinal aspect: duration of a patient–physician(s) relationship, link past–present–future (relational continuity).

2. Quality of the relationship (relational continuity).

3. Coherence of management plan, coordination (management continuity).

4. Timely availability of information (informational continuity).