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Related Experiment Videos

How much personal care in four group practices?

G K Freeman1, S C Richards

  • 1Primary Medical Care Group, Aldermoor Health Centre, Southampton.

BMJ (Clinical Research Ed.)
|November 3, 1990
PubMed
Summary
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Continuity of care in general practice is lower in group practices, especially for younger patients. Personal lists improve continuity, but combined lists show fragmented care, impacting clinical responsibility.

Area of Science:

  • General Practice and Primary Care
  • Health Services Research
  • Patient Care Coordination

Background:

  • Continuity of care is a key aspect of general practice.
  • Group practices may present challenges to maintaining consistent patient-doctor relationships.
  • Understanding continuity levels is crucial for evaluating primary care models.

Purpose of the Study:

  • To quantify the degree of continuity of care within general practice settings.
  • To compare continuity levels between practices with personal versus combined doctor lists.
  • To identify patient factors associated with continuity of care.

Main Methods:

  • Retrospective analysis of patient records from four large group practices.
  • Inclusion criteria: registered for at least two years, with at least 12 consultations over six years.

Related Experiment Videos

  • Continuity score calculated based on consultations with the usual doctor.

    • Main Results:

    • Practices with personal lists achieved 83% continuity (10/12 consultations with the same doctor).
    • Practices with combined lists showed significantly lower continuity (49-58%).
    • Higher continuity was associated with older age and recording of major health problems.

    Conclusions:

    • Personal continuity of care in group practices can be low, particularly for younger/healthier patients in combined list systems.
    • Findings support group-based financial incentives over individual ones but raise questions about individual clinical responsibility.
    • The study highlights the impact of practice organization on patient care continuity.