Measuring continuity of care in general practice: a comparison of two methods using routinely collected data

Area of Science:

• Primary Care Medicine
• Health Services Research
• Epidemiology

Background:

• Longitudinal doctor-patient continuity in primary care offers significant clinical benefits.
• However, continuity rates have been observed to be declining.
• Practices and health commissioners rarely assess these continuity rates.

Purpose of the Study:

• To measure doctor-patient continuity across 126 primary care practices in East London.
• To compare continuity scores with patient survey responses regarding General Practice continuity.
• To investigate factors influencing continuity rates.

Main Methods:

• A retrospective, cross-sectional study design was employed.
• The Usual Provider of Care (UPC) score was used to measure continuity.
• Data from electronic health records and the General Practice Patient Survey (GPPS) were analyzed for patients with at least three consultations.

Main Results:

• The mean UPC score across practices was 0.52, with significant variation (range 0.32-0.93).
• A strong positive correlation (r=0.62) was found between UPC scores and GPPS responses on patient preference for a specific doctor.
• Higher continuity was observed in smaller practices and for older patients (≥65 years) and females.

Conclusions:

• Continuity of care can be effectively measured across primary care practices within a local health economy.
• Regular monitoring of continuity rates can support interventions to improve care continuity.
• Enhancing continuity is likely to positively impact clinical outcomes and patient/doctor satisfaction.