Table 4.

Crude and adjusted associations between patient–doctor continuity and time to diagnosis of breast, colorectal, and lung cancer

CovariateBreastColorectalLung
Crude time ratio (95% CI)P-valueAdjusted time ratio (95% CI)P-valueCrude time ratio (95% CI)P-valueAdjusted time ratio (95% CI)P-valueCrude time ratio (95% CI)P-valueAdjusted time ratio (95% CI)P-value
Patient–doctor continuitya1.01 (1.00 to 1.02)0.281.00 (0.99 to 1.01)0.901.00 (0.99 to 1.00)0.211.01 (1.01 to 1.02)<0.010.98 (0.98 to 0.99)<0.011.00 (0.99 to 1.00)0.33
Number of consultations1.00 (1.00 to 1.00)0.671.00 (1.00 to 1.00)0.071.02 (1.02 to 1.02)<0.011.02 (1.01 to 1.02)<0.011.01 (1.01 to 1.02)<0.011.01 (1.01 to 1.01)<0.01
Patient
  Age0.99 (0.99 to 0.99)<0.010.99 (0.99 to 1.00)<0.011.00 (1.00 to 1.00)<0.011.00 (1.00 to 1.00)<0.011.00 (1.00 to 1.00)<0.011.00 (1.00 to 1.00)0.20
  Femalen/an/a1.08 (1.04 to 1.13)<0.011.05 (1.01 to 1.09)0.031.06 (1.02 to 1.10)<0.011.03 (0.99 to 1.07)0.12
  Multimorbidity0.95 (0.93 to 0.97)<0.010.97 (0.95 to 1.000.041.06 (1.04 to 1.08)<0.010.99 (0.98 to 1.01)0.481.06 (1.05 to 1.08)<0.011.02 (1.01 to 1.04)<0.01
  Risk factorb0.96 (0.79 to 1.15)0.640.92 (0.77 to 1.10)0.351.22 (1.02 to 1.47)0.031.15 (0.96 to 1.37)0.131.30 (1.24 to 1.35)<0.011.19 (1.14 to 1.24)<0.01
  Current smokern/an/an/an/a0.95 (0.92 to 0.99)0.020.90 (0.85 to 0.95)<0.01
  Ex-smokern/an/an/an/a1.03 (0.99 to 1.07)0.130.91 (0.86 to 0.95)<0.01
Index doctor
  Female0.92 (0.87 to 0.98)0.010.92 (0.86 to 0.98)0.011.02 (0.98 to 1.07)0.251.03 (0.99 to 1.08)0.151.02 (0.99 to 1.07)0.171.00 (0.96 to 1.04)0.96
Status
  Salaried0.92 (0.68 to 1.25)0.590.91 (0.67 to 1.23)0.460.94 (0.74 to 1.19)0.720.86 (0.68 to 1.09)0.450.99 (0.80 to 1.24)0.081.02 (0.82 to 1.27)0.15
  Locum1.05 (0.93 to 1.20)1.07 (0.94 to 1.21)0.97 (0.89 to 1.06)1.00 (0.92 to 1.10)0.92 (0.85 to 0.99)0.93 (0.86 to 1.00)
Consultation type
  Surgery1.14 (1.02 to 1.29)0.041.13 (1.01 to 1.26)0.161.00 (0.91 to 1.08)0.170.99 (0.91 to 1.08)0.191.07 (0.98 to 1.16)<0.011.08 (0.99 to 1.17)<0.01
  Telephone1.24 (0.94 to 1.63)1.22 (0.94 to 1.58)1.11 (0.98 to 1.27)1.02 (0.90 to 1.16)1.09 (0.97 to 1.24)1.01 (0.90 to 1.14)
  Visit0.99 (0.82 to 1.20)1.15 (0.95 to 1.38)0.98 (0.88 to 1.10)0.91 (0.82 to 1.02)0.96 (0.86 to 1.06)0.92 (0.83 to 1.01)
Symptoms/signs
  Number1.38 (0.94 to 2.01)0.101.42 (0.98 to 2.05)0.060.89 (0.81 to 0.98)0.030.96 (0.87 to 1.06)0.440.99 (0.91 to 1.07)0.740.99 (0.91 to 1.07)0.75
  High-risk0.32 (0.28 to 0.37)<0.010.34 (0.29 to 0.39)<0.010.68 (0.65 to 0.71)<0.010.72 (0.69 to 0.75)<0.010.66 (0.61 to 0.70)<0.010.70 (0.65 to 0.74)<0.01
  • a Modified fraction-of-care index (f’); continuity defining period before and after index consultation.

  • b Breast cancer: family history of breast cancer; colorectal cancer: ulcerative colitis; lung cancer: chronic obstructive pulmonary disease. n/a = not applicable.