Evaluation of Continuity of Care: What Can Physician Survey Add?

Abstract

Background: The evaluation of continuity of care is usually based on the indicators of the frequency of patients’ contacts with specific providers. There are some first attempts to use physician survey for the evaluation. Objective: Is to get additional information on the continuity of care in Russia by a newly developed physician questionnaire with detailed questions related to the specific areas of providers’ interaction in the health system. Methods: The questionnaire was developed to increase the number of characteristics and indicators for the evaluation of informational, longitudinal and interpersonal continuity. Each of 17 questions was pretested by a group of experts. A small physician survey was conducted through the mobile App with 2690 respondents. A sample is skewed to young and urban respondents. The attempts have been made to increase its representativeness. Results and discussion: We identified the areas of low continuity of care in Russia. Access to electronic medical records is limited. Outpatient and inpatient physicians rarely contact with each other. Primary care physicians are unaware of the substantial part of hospital admissions and emergency visits of their patients, which makes them unprepared for the follow-up treatment. Home visits to patients with heart attack and stroke after hospital discharge are rare. The lack of timely transfer of hospital cases to rehabilitative and social care settings also limits continuity of care. However, a small scale of the survey and its online operation limit its representativeness and robustness. Bigger scale of the survey with the same or similar questionnaire can improve its results. Conclusion: Physician survey can be a useful instrument of care continuity evaluation. The content of the suggested survey can be valuable for collecting the international evidence.