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Predicting declines in perceived relationship continuity using practice deprivation scores: a longitudinal study in
Louis S Levene1, Richard Baker1, Nicola Walker1
1Department of Health Sciences, College of Life Sciences, George Davies Centre for Medicine, University of Leicester, Leicester.
Summary
Patient relationship continuity in primary care declined significantly between 2012 and 2017. Socioeconomic deprivation did not predict this decline, highlighting the need for universal strategies to maintain continuity of care.
Area of Science:
- Primary Care Research
- Health Services Research
- Socioeconomic Determinants of Health
Background:
- Increased relationship continuity in primary care is linked to improved health outcomes, patient satisfaction, and reduced hospital admissions.
- Higher socioeconomic deprivation correlates with lower continuity of care and poorer health.
- Understanding the interplay between deprivation and continuity is crucial for equitable healthcare.
Purpose of the Study:
- To examine if socioeconomic deprivation scores predicted changes in patient-perceived relationship continuity over time.
- To adjust for practice-level organizational and population factors in the analysis.
Main Methods:
- An observational study analyzed data from 6243 primary care practices in England between 2012 and 2017.
- Patient-perceived relationship continuity was measured using the GP Patient Survey.
- Longitudinal multilevel linear models were employed, accounting for confounding variables and practice clustering.
Main Results:
- Relationship continuity decreased by 27.5% from 2012 to 2017 across all deprivation levels.
- Deprivation scores did not predict variations in the decline of relationship continuity after adjusting for other factors.
- Continuity and deprivation showed a negative cross-sectional correlation annually.
Conclusions:
- A significant and widespread decline in relationship continuity of care was observed.
- Strategies to enhance continuity must be practical for diverse primary care settings.
- Further research is needed to identify effective interventions for maintaining continuity.
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