EVIDENCE ON BENEFITS OF CONTINUITY

Our 2016 review on continuity of care can be read here.

You can also watch Sir Denis Pereira Gray talk about the benefits of continuity in Webinar 1 on the Royal College of General Practitioners' website.

 

Continuity has been shown to have benefits for both patients and doctors. We summarise eight core benefits for patients which are well demonstrated in the research literature.

 

When they receive continuity of doctor care, patients:

  1. Are more satisfied. (Baker and Streatfield 1995, Baker et al 2003, Adler et al 2010

  2. Are more likely to follow medical advice (Warren et al 2015Chen et al 2013)

  3. Are more likely to take up offers of personal preventive medicine. (O’Malley et al 1997, Christakis et al 2000)

  4. Are more likely to have a good doctor patient relationship with their GP. (Mainous et al 2001, Ridd et al 2011

  5. Are more likely to receive good quality of care. (O’Connor et al 1998, Romano and Segal 2015)

  6. Are less likely to need to go to A&E. (Brousseau  et al 2004, van den Berg et al 2016)

  7. Are less likely to need a hospital admission, particularly for ambulatory care sensitive conditions. (Barker et al 2017Bankart et al 2011)

  8. Are likely to live longer. (Maarsingh et al 2016, Pereira Gray et al 2018)

 

 

These key features have many different research studies underpinning them and we have simply selected two or three for each for the sake of simplicity and to keep the number of references low. We are happy to supply additional references to those who are interested.

 

BENEFITS FOR DOCTORS

There are also advantages for GPs of continuity of care:

  1. Accumulated knowledge- with continuity, GPs gain more accumulated knowledge of their patients and use it for the patient’s benefit (Hjortdahl & Borchgrevink 1991, Hjortdahl 1992, Ridd et al 2011)

  2. GP satisfaction- personal knowledge of the patient and the doctor–patient relationship and personal continuity enable GPs to provide ‘higher-quality care’ (Ridd et al 2006)

  3. Better adherence/concordance with the doctor’s advice- patients are easier to work with when they disclose more information and when advice is followed. (Chen et al 2013, Warren et al 2015)

  4. Efficiency in practice administration- general practices run more efficiently, when staff are clear about who is the responsible GP. With personal lists queries and test results can be transmitted quickly to the patient’s responsible  doctor (Pereira Gray 1979)

  5. Internal professional audits- personal list practices can conduct internal practice audits on the performance of doctors. These internal inter-doctor audits are highly educational, sustain quality improvement, with privacy for the clinicians if weaknesses are exposed. (Pereira Gray 1995)

  6. Forgiveness- Patients forgive some practice errors within strong patient–doctor relationships (Lings et al 2003)

 
 

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