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The National Health Insurance database was used and 333,294 patients were identified from 2007 to 2009. The continuity of care index indicates the dispersion of a patient\u2019s ambulatory visits among providers. Multivariate logistic regression was used to estimate adjusted odds ratios with 95\u2009percent confidence intervals. Continuity of care index was significantly associated with age, sex, urbanization level, socioeconomic status, emergency department visits, hospitalization, psychological disorders, chronic diseases, and catastrophic illness card; those with low continuity of care index were likely to use outpatient care highly frequently. Improving continuity of care is fundamental, and the best way is to advance the practice of family medicine for primary care.<\/jats:p>","DOI":"10.1177\/1460458218824720","type":"journal-article","created":{"date-parts":[[2019,1,31]],"date-time":"2019-01-31T12:01:42Z","timestamp":1548936102000},"page":"318-327","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":24,"title":["Continuity of care and multiple chronic conditions impact frequent use of outpatient services"],"prefix":"10.1177","volume":"26","author":[{"given":"Chi","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsiao-Ching","family":"Kuo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Su-Fen","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jui-Lan","family":"Hung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia-Hui","family":"Xiong","sequence":"additional","affiliation":[{"name":"Kaohsiung Veterans General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5312-1477","authenticated-orcid":false,"given":"Pei-Ling","family":"Tang","sequence":"additional","affiliation":[{"name":"Meiho University; Kaohsiung Medical University; Kaohsiung Veterans General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,1,31]]},"reference":[{"key":"bibr1-1460458218824720","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e31826c870f"},{"key":"bibr2-1460458218824720","doi-asserted-by":"publisher","DOI":"10.1002\/hec.1160"},{"key":"bibr3-1460458218824720","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-148-4-200802190-00004"},{"key":"bibr4-1460458218824720","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.162.20.2269"},{"key":"bibr5-1460458218824720","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000000061"},{"key":"bibr6-1460458218824720","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa063979"},{"key":"bibr7-1460458218824720","first-page":"21","volume":"6","author":"Gomel\u2019skaia GL","year":"1981","journal-title":"Sov Zdravookhr"},{"key":"bibr8-1460458218824720","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-007-0182-8"},{"key":"bibr9-1460458218824720","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1984.03350170015011"},{"key":"bibr10-1460458218824720","doi-asserted-by":"publisher","DOI":"10.1001\/archfami.9.4.333"},{"key":"bibr11-1460458218824720","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.061615"},{"key":"bibr12-1460458218824720","doi-asserted-by":"publisher","DOI":"10.1370\/afm.75"},{"key":"bibr13-1460458218824720","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-012-2287-y"},{"key":"bibr14-1460458218824720","doi-asserted-by":"publisher","DOI":"10.1097\/NNR.0b013e318298aa55"},{"issue":"3","key":"bibr15-1460458218824720","first-page":"e61","volume":"20","author":"Higgins S","year":"2014","journal-title":"Am J Manag Care"},{"key":"bibr16-1460458218824720","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-197704000-00010"},{"key":"bibr17-1460458218824720","doi-asserted-by":"publisher","DOI":"10.1370\/afm.1080"},{"key":"bibr18-1460458218824720","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.12032"},{"key":"bibr19-1460458218824720","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthpol.2009.08.009"},{"key":"bibr20-1460458218824720","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-6-54"},{"key":"bibr21-1460458218824720","doi-asserted-by":"publisher","DOI":"10.1136\/emermed-2013-202369"},{"key":"bibr22-1460458218824720","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000001205"},{"key":"bibr23-1460458218824720","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2012.11.042"},{"key":"bibr24-1460458218824720","doi-asserted-by":"publisher","DOI":"10.1177\/1355819616649630"},{"key":"bibr25-1460458218824720","doi-asserted-by":"publisher","DOI":"10.1111\/acem.13060"},{"key":"bibr26-1460458218824720","doi-asserted-by":"publisher","DOI":"10.1136\/emermed-2014-204496"},{"key":"bibr27-1460458218824720","doi-asserted-by":"crossref","unstructured":"Sheaff R, Halliday J, Ovretveit J, et al. 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