Preventive care and continuity of attendance. Is there a risk?

To explore whether there are associations between continuity of care and the provision of items of preventive care in Australian general practice.

Patient completed questionnaires from a 'consecutive' sample of Australian general practitioners enrolled in the Patient Participation Program of the Quality Assurance and Continuing Medical Education Program of the Royal Australian College of General Practitioners.

An association was sought between the length of time patients reported attending their practitioner, whether they regularly attended more than one practice, and whether they were provided with preventive care.

Data from 12,605 questionnaires, completed by patients from 133 practices throughout Australia found that patients who reported only visiting one practice on a regular basis were significantly more likely to report the provision of: blood pressure screening within the past 12 months; cholesterol screening in the past 5 years; adequate smoking cessation information if required; to have discussed the benefits of diet and exercise; to have received a cervical smear in the past 2 years; and to have received adequate instruction in the technique of breast self examination. Patients attending the same practices for longer periods were significantly more likely to have received the above items with the exception of adequate information to enable them to stop smoking if they desired; and cervical smears in the past 2 years. Such patients were less likely to report the provision of tetanus immunisation in the past 10 years and cervical smears in the past 2 years.

Patients reporting greater continuity of care measured by only consulting at one practice or visiting the practice for a longer time period reported a greater provision of preventive care than patients who did not report these characteristics.