The wall of evidence for continuity of care

Background: A long-term relationship between a patient and their doctor, known as continuity of care, has seen a decline in recent decades in both the UK and the U.S. This decline has negatively impacted patient and physician health outcomes and  well-being.

Editorial Stance: Building on Terrence McDonald and colleagues' research, which distinguishes between the continuity contributions of a practice and an individual clinician, increased physician continuity has been linked to reduced emergency department usage for all patients and lower hospitalization for those with higher patient complexity. Notably, patients consistently seeing their regular family physician or a partner at the same practice had the best health outcomes. The author notes that this evidence is crucial and points to practical solutions that increase physician awareness of continuity's benefits and underscore the relationship between continuity and key health outcomes.

Why It Matters: Gradual benefits of improved continuity suggest that solutions don't have to be all-or-nothing but can come from various strategies that together enhance overall care. Possible improvements include 'buddy' systems among doctors, the use of e-health options, and focused training for family physician trainees on delivering continuity of care. These methods represent stepwise changes that can collectively improve continuity of care.

The Wall of Evidence for Continuity of Care: How Many More Bricks Do We Need?

Otto R. Maarsingh, MD, PhD

Department of General Practice, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health, Amsterdam, The Netherlands

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