[Continuity and longitudinal aspects of care in general practice in four European countries]

The objective of the study was to compare continuity and longitudinality of care in general practice in four European countries with a public salary model.

Descriptive and prospective study. 63 general practitioners/family physicians working in public health centers registered all encounters (direct and indirect) over a period of one week in Spain, Finland, Portugal and Sweden.

92% of the contacts were office encounters: 75% were direct (face to face), the average number of encounters per doctor, per week was 103. The principal problem was chronic in 42% of cases and acute in 31%. The physician has previous knowledge of the principal problem in 63% of the encounters and previous knowledge of concurrent problems in 79%. In 66% of cases the doctor has previous knowledge of the patient relatives.

The level of continuity and longitudinality is variable; from high to low: Portugal, Spain, Sweden and Finland. In Spain the duration of the encounter is short and repeated prescription are infrequent. In Portugal there are waitings lists which implies low accessibility for acute problems. In Finland general practitioners have no patients lists and the care is des-personalized. In Sweden there are waiting lists and high use of telephone encounters.