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Association of General Practice Continuity With Hospital Admissions and Costs: A Retrospective Study
Marije T Te Winkel1,2, Annemarie A Uijen3, Birgit I Lissenberg-Witte4
1Department of General Practice, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Annals of Family Medicine
|June 30, 2026
Summary
Long-term relationships with general practitioners (GPs) significantly reduce urgent hospital admissions and healthcare costs. Sustained GP-patient continuity of care improves hospital outcomes and demonstrates the value of primary care.
Area of Science:
- Health Services Research
- Primary Care Medicine
- Health Economics
Background:
- Continuity of care is linked to reduced healthcare utilization and costs.
- General practitioners (GPs) acting as gatekeepers may enhance efficiency and lower costs through ongoing patient relationships.
- The study investigates how different measures of general practice continuity affect urgent hospital admissions and costs.
Purpose of the Study:
- To examine the association between two distinct measures of continuity in general practice and urgent hospital admissions.
- To assess the relationship between general practice continuity and overall hospital costs.
- To determine the impact of sustained GP-patient relationships on healthcare resource utilization.
Main Methods:
- A retrospective cohort study utilized healthcare data from 100,450 adults across 48 Dutch general practices (2013-2018).
- Continuity was measured by the duration of the GP-patient relationship and the density of GP contacts (Herfindahl-Hirschman index).
- Associations with urgent admissions and hospital costs were analyzed using multilevel logistic and linear models, controlling for demographic and socioeconomic factors.
Main Results:
- Patients registered longer with their GP practice showed significantly lower odds of urgent hospital admission (9%-21% reduction).
- Longer registration periods (over 5 years) were associated with significantly lower hospital costs, with a notable reduction of -39.7% for 10-15 years registration.
- Higher density of GP contacts correlated with reduced total hospital costs (6%-7% relative reduction), but not with urgent admissions.
Conclusions:
- Long-standing continuity of care in general practice is associated with decreased urgent hospital admissions and healthcare expenditures in the Netherlands.
- Sustained GP-patient relationships appear to be valuable for enhancing hospital outcomes.
- The findings underscore the importance of continuity in primary care for efficient and cost-effective healthcare delivery.
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