Grant: Master's Award: Canada Graduate Research Scholarships - Master's program

Objective: This thesis examines whether continuity of care is equally impactful across primary care settings for adults with serious mental illness (SMI) in British Columbia. Background: Ongoing relationships between patients and their usual care providers have been linked to fewer hospitalizations, reduced emergency department (ED) visits, and improved symptom management for people with SMI. However, this population faces fragmented care and difficulty accessing comprehensive primary care. Little is known about whether the benefits of continuity differ across practice settings such as comprehensive family practice, walk-in clinics, and episodic virtual care, or whether continuity is less effective in environments that offer a limited scope of care. Methods: Using administrative health data from Population Data British Columbia, I will create two adult cohorts: one including individuals with SMI (schizophrenia spectrum disorder, bipolar disorder, or who were hospitalized for mental illness) and one including individuals without SMI. Descriptive analyses will summarize patterns of service use across settings. Generalized linear models will estimate the relationship between continuity and all-cause ED visits and hospitalizations, and will test whether primary care setting moderates this relationship. Sensitivity analyses will use multiple measurements of continuity, including the Usual Provider of Care Index, Bice-Boxerman Index. Impact: This research will inform provincial efforts to strengthen primary care by identifying whether continuity must be supported differently across care environments, particularly for people with complex needs. Findings will guide policy makers in aligning primary care structures with the needs of individuals with and without SMI.