Max Rady College of Medicine

Term: Continuity of Care Index (COCI)

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Glossary Definition

Last Updated: 2020-02-26


The Continuity of Care Index (COCI) is an indicator that weighs both the frequency of ambulatory visits to primary care providers (which includes family physicians and nurse practitioners; mdbloc = 11, 200 respectively) and the dispersion of ambulatory visits between family physicians and nurse practitioners. The possible index values range from just greater than zero (where visits are made to different providers) to one (all visits made to the same provider)

Different types of providers can be selected to this index such as individual physician, a physician group practice, a clinic or primary care providers. For example, in Katz et al. (2014), they created an index that measures COC to a Physician Integrated Network (PIN) clinic rather than by individual physician. In this scenario, a value of zero on the index represents all visits made to a different clinic and a value of one represents all visits made to the same PIN clinic.

In addition, different requirements can be applied. For example, in Katz et al. (2014), people who had fewer than three ambulatory visits to a family physician in a two-year period were excluded from the analysis. In Frohlich et al. (2006), they constructed the COCI for each physician based on core patients with two or more visits (to any physician, including primary care paediatricians) in the study year.

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  • Frohlich N, Katz A, De Coster C, Dik N, Soodeen RA, Watson D, Bogdanovic B. Profiling Primary Care Physician Practice in Manitoba. Winnipeg, MB: Manitoba Centre for Health Policy, 2006. [Report] [Summary] (View)
  • Katz A, Chateau D, Bogdanovic B, Taylor C, McGowan K-L, Rajotte L, Dziadek J. Physician Integrated Network: A Second Look. Winnipeg, MB: Manitoba Centre for Health Policy, 2014. [Report] [Summary] [Updates and Errata] (View)
  • Katz A, Avery Kinew K, Star L, Taylor C, Koseva I, Lavoie J, Burchill C, Urquia M, Basham A, Rajotte L, Ramayanam V, Jarmasz J, Burchill S. The Health Status of and Access to Healthcare by Registered First Nation Peoples in Manitoba. Winnipeg, MB: Manitoba Centre for Health Policy, 2019. [Report] [Summary] [Updates and Errata] [Additional Materials] (View)

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Community Health Sciences, Max Rady College of Medicine,
Rady Faculty of Health Sciences,
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University of Manitoba
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