Export file:


  • RIS(for EndNote,Reference Manager,ProCite)
  • BibTex
  • Text


  • Citation Only
  • Citation and Abstract

Parents’ perception and willingness to maintain provider care continuity for their children under universal health coverage

1 Department of Public Health, National Yang-Ming University, Taipei 112, Taiwan
2 Department of Pediatrics, Taipei Hospital, Ministry of Health and Welfare, Taiwan
3 School of Medicine, National Yang-Ming University, Taipei 112, Taiwan
4 College of Public Health, China Medical University, Taichung 40402, Taiwan
5 College of Public Health, National Taiwan University, Taipei 10055, Taiwan
† These two authors contributed equally.

Background: Provider continuity of care (COC) is closely related to patient outcome in pediatrics. However, no study has investigated how parents perceive the importance of COC and whether their perceptions affect their willingness to make effort to maintain good provider COC for their children under universal health coverage. Methods: A cross-sectional survey was conducted between August 2017 and February 2018 across 6 different practices: 2 medical centers, 2 regional hospitals, 1 district hospital, and 1 clinic (n = 825). Parents’ and caregivers’ perceptions and perceived value of COC were evaluated using 7 items. The contingent valuation method was used to estimate willingness to pay and spend time. Results: Of all respondents, only 47% (n = 394) were willing to spend >30 minutes to have their children see the regular physician if the regular physician relocated. Approximately 38% (n = 302) respondents were willing to pay more than New Taiwan Dollar (NT$) 300 per month to maintain provider COC. The perception that high COC is important was associated with willingness to spend more time for maintaining high provider COC. Conclusion: Parents’ perception of COC does not affect their willingness to pay for maintaining high provider COC for their children but affects their willingness to spend more time to maintain COC.
  Article Metrics


1. Wall E (1981) Continuity of care and family medicine: definition, determinants, and relationship to outcome. J Fam Pract 13: 655–664.

2. Saultz JW (2003) Defining and measuring interpersonal continuity of care. Ann Fam Med 1: 134–143.    

3. Freeman G, Hughes J (2010) Continuity of care and the patient experience.

4. Christakis DA, Mell L, Koepsell TD, et al. (2001) Association of lower continuity of care with greater risk of emergency department use and hospitalization in children. Pediatrics 107: 524–529.    

5. Cyr MC, Martens AC, Berbiche D, et al. (2006) Continuity of care in the ambulatory treatment of adolescents with asthma. J Adolesc Health 39: 926.e911–926.e917.

6. Huang ST, Wu SC, Hung YN, et al. (2016) Effects of continuity of care on emergency department utilization in children with asthma. Am J Manag Care 22: e31–37.

7. Utidjian LH, Fiks AG, Localio AR, et al. (2017) Pediatric asthma hospitalizations among urban minority children and the continuity of primary care. J Asthma 54: 1051–1058.    

8. Johnston DL, Halton J, Bassal M, et al. (2017) Pediatric Oncology Clinic Care Model: Achieving Better Continuity of Care for Patients in a Medium-sized Program. J Pediatr Hematol Oncol 39: 476–480.    

9. Siow E, Wypij D, Berry P, et al. (2013) The effect of continuity in nursing care on patient outcomes in the pediatric intensive care unit. J Nurs Adm 43: 394–402.    

10. Brousseau DC, Meurer JR, Isenberg ML, et al. (2004) Association between infant continuity of care and pediatric emergency department utilization. Pediatrics 113: 738–741.    

11. Haggerty JL, Reid RJ, Freeman GK, et al. (2003) Continuity of care: a multidisciplinary review. BMJ 327: 1219–1221.    

12. McWhinney I (1975) Continuity of care in family practice. Part 2: implications of continuity. J Fam Pract 2: 373–374.

13. Pandhi N, Saultz JW (2006) Patients' perceptions of interpersonal continuity of care. J Am Board Fam Med 19: 390–397.    

14. Gulliford M, Cowie L, Morgan M (2011) Relational and management continuity survey in patients with multiple long-term conditions. J Health Serv Res Policy 16: 67–74.    

15. Waibel S, Henao D, Aller MB, et al. (2011) What do we know about patients' perceptions of continuity of care? A meta-synthesis of qualitative studies. Int J Qual Health Care 24: 39–48.

16. Mainous AG, Baker R, Love MM, et al. (2001) Continuity of care and trust in one's physician: evidence from primary care in the United States and the United Kingdom. Fam Med 33: 22–27.

17. Guo JY, Chou YJ, Pu C (2017) Effect of Continuity of Care on Drug-Drug Interactions. Med Care 55: 744–751.    

18. Bice TW, Boxerman SB (1977) A quantitative measure of continuity of care. Med Care 15: 347–349.    

19. Tsai HY, Chou YJ, Pu C (2015) Continuity of care trajectories and emergency room use among patients with diabetes. Int J Public Health 60: 505–513.    

20. Guerriero C, Cairns J, Bianchi F, et al. (2018) Are children rational decision makers when they are asked to value their own health? A contingent valuation study conducted with children and their parents. Health Econ 27: e55–e68.

21. Lu JFR, Hsiao WC (2003) Does universal health insurance make health care unaffordable? Lessons from Taiwan. Health Aff (Millwood) 22: 77–88.

22. Little RJ (1993) Post-stratification: a modeler's perspective. J Am Stat Assoc 88: 1001–1012.    

23. West BT (2008) Statistical and methodological issues in the analysis of complex sample survey data: practical guidance for trauma researchers. J Trauma Stress 21: 440–447.    

24. Pereira AG, Pearson SD (2003) Patient attitudes toward continuity of care. Arch Intern Med 163: 909–912.    

25. Lewis CL, Wickstrom GC, Kolar MM, et al. (2000) Patient preferences for care by general internists and specialists in the ambulatory setting. J Gen Intern Med 15: 75–83.    

26. Love MM, Arch III G (1999) Commitment to a regular physician: how long will patients wait to see their own physician for acute illness? J Fam Pract 48: 202.

27. Cheraghi-Sohi S, Hole AR, Mead N, et al. (2008) What patients want from primary care consultations: a discrete choice experiment to identify patients' priorities. Ann Fam Med 6: 107–115.    

28. Christakis DA (2003) Continuity of care: process or outcome? Ann Fam Med 1: 131–133.    

29. Bailey T (2007) The evolution of family medicine. Can Fam Physician 53:1113–1114.

© 2019 the Author(s), licensee AIMS Press. This is an open access article distributed under the terms of the Creative Commons Attribution Licese (http://creativecommons.org/licenses/by/4.0)

Download full text in PDF

Export Citation

Article outline

Show full outline
Copyright © AIMS Press All Rights Reserved