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Beyond single encounters: a mixed methods study of access to continuous asthma care using Levesque's framework
Irem Sevik1,2, Meltem Ciceklioglu3, Gulistan Karadeniz4
1Van Başkale District Health Authority, Van, Turkey. iremsevik@gmail.com.
BMC Pulmonary Medicine
|July 17, 2026
Summary
Access to continuous asthma care is limited for adults, with only 29.2% receiving it. Clear physician explanations and well-controlled asthma significantly improve continuity, highlighting primary care
Area of Science:
- Healthcare Access and Quality
- Chronic Disease Management
- Health Services Research
Background:
- Asthma symptom control relies on consistent follow-up and continuous care, crucial for quality of life and reducing healthcare costs.
- Inadequate asthma control negatively impacts patients' quality of life and increases healthcare utilization.
- This study investigates continuous care access and influencing factors in adult asthma patients at tertiary care centers, exploring patient experiences.
Purpose of the Study:
- To examine access to continuous care among adult asthma patients in tertiary care.
- To identify factors associated with continuous care access in this population.
- To explore patient experiences and the dynamics of care continuity in asthma management.
Main Methods:
- An explanatory sequential mixed-methods study using a critical realist paradigm and Levesque's framework.
- Quantitative phase: 312 participants analyzed with SPSS using Chi-square, Fisher's exact, t-tests, and logistic regression.
- Qualitative phase: 12 participants interviewed via semi-structured, in-depth interviews, analyzed with critical grounded theory.
Main Results:
- Only 29.2% of adult asthma patients reported access to continuous care.
- Clear physician explanations (OR=3.30) and well-controlled asthma (OR=2.67) were strong determinants of continuity.
- Patients experienced delayed diagnoses, insufficient primary care involvement, and care fragmentation, particularly those with comorbidities.
Conclusions:
- Access to continuous care for asthma patients remains a significant challenge.
- Enhancing primary care diagnosis, follow-up, and referral processes is essential.
- Improved inter-institutional coordination and guideline-based asthma management are necessary.
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