Practices that provide patients with continuity of care help reduce mortality rates, according to a major review of the international evidence published this week.
Researchers found 13 studies for their report in the British Journal of General Practice. 12 of these linked continuity of care with all cause mortality – and nine found a statistically significant protective effect, the researchers report.
The researchers, led by Professor Richard Baker, of Leicester University, UK, say that varying methods have been used to measure continuity of care. Some analyse patient contacts with individual doctors while others use reports from patients themselves. Improved clinical responsibility, physician knowledge, and patient trust may all contribute to the positive link, they say. The studies in the analysis came from England, the USA, Canada, Austria, France, Israel, South Korea and the Netherlands.
The researchers call for experimental research, adding: “Policymakers may aim to improve efficiency, even at the price of impersonal care, but should realise that the resulting discontinuities could make matters worse for patient satisfaction, hospital use, and, probably, mortality. New patterns of care must be designed to avoid these outcomes.”
Professor Martin Marshall, chair of the Royal College of GPs, said: “When considering the future of general practice, it’s vital that we place continuity of care at the forefront of our minds. We know the trusted GP-patient relationship is something many patients value most about general practice. It is unique, often built over time – and it allows GPs to deliver the holistic, relationship-based care that they excel at delivering. And this study in the British Journal of General Practice adds to the mounting evidence that continuity of care can benefit patients in many ways.”
He added: “While GPs and our teams will embrace technology and new ways of working, it’s imperative that we retain continuity of care, regardless of how we interact with our patients and deliver general practice services. We understand that some patients value convenience over continuity, and it’s important that those patients’ needs are met, but those who do value continuity, who are often our patients who have complex, long-term health conditions, it must be made available to them.”