Older patients who experience more discontinuity of care in general practice are at higher risk of emergency hospital admissions. In a UK study of 10,000 randomly selected patients over age 65, medical records were linked with hospital episode statistics. The study used two research approaches: a prospective cohort approach to assess the general impact of continuity of care on emergency admission, and a nested case-control approach to test if seeing a different GP from usual increases the risk of emergency admission during the following 30 days. The prospective approach found a graded non-significant inverse relationship between continuity of care and risk of emergency hospitalization, though patients experiencing least continuity had a risk more than twice as high than those who had complete continuity. The retrospective approach found a graded inverse relationship between continuity of care and emergency hospitalization, with an odds ratio of 2.32 for those experiencing least continuity compared with those with most continuity. Initiatives to enhance continuity of care, the authors suggest, could potentially reduce hospital admissions.
Continuity of Primary Care and Emergency Hospital Admissions Among Older Patients in England
Peter Tammes, MA, PhD, et al
University of Bristol, Bristol, UK
The Annals of Family Medicine