Sequential continuity of care by general practitioners: which patients change doctor?

Abstract

Objective: To identify individual and social characteristics of patients making sequential visits to a different rather than the same general practitioner (GP). was treated as an event.Participants: 521 subjects aged between 23 and 72 years who gave consent to release of Health Insurance Commission data.Main outcome measure: A visit to the same GP or a different GP from the one seen at the last visit.Results: Logistic regression analysis showed that younger age, good physical functioning, good self-rated health, normal body mass index, shiftwork and a longer time interval between visits were significantly associated with less continuity of care. Conclusions:Our study raises questions about the relationship between chronological continuity and quality of care. For example, if infrequent visits (associated with less continuity) are for distinct illnesses, is quality of care affected by information or treatment from a previous visit? Our results also suggest that some GPs, because of the demography of their practices (more young people, a higher proportion of shift workers), may be disadvantaged by continuity-based reward systems. Moreover, because of lack of continuity young people may miss out on GPs' health promotional activities.

Informed consent for record linkage: a systematic review

“…One article15 was published in 1996 and 10 articles were published after 2000. The studies were carried out in Canada, UK, Australia and Taiwan.…”

Defining and Measuring Interpersonal Continuity of Care

“…A recently published report from the Canadian Health Services Foundation has addressed the confusion regarding the definition of continuity of care. 146 One [30][31][32]34,[36][37][38][39][40] Christakis et al, 1999 118 Flynn, 1985 45 Roos et al, 1980 36 Sloane & Eglehoff, 1983 75 Wasson et al, 1984 66 Number of Providers Seen Raddish et al, 1999 117 (NOP) 20 Shortell et al, 1977 49 Sequential Continuity Index Phillips & Shear, 1984 88 (SECON) 20,34,37,38,40 Pilotto et al, 1996 73 Shear et al, 1983 64 Wasson et al, 1984 66 Likelihood of Continuity Index (LICON) 20,34,38 Likelihood of Sequential Continuity Index (LISECON) 20,38 Herfindahl Index (HH) 20,39 Modified Continuity Index Gill & Mainous, 1998 90 (MCI) 31,37 Gill et al, 2000 115 Neher et al, 2001 124 Sturmberg & Schattner, 2001 100 Modified, Modified Continuity Gill & Mainous, 1998 90 Index (MMCI) 31 Gill et al, 2000 115 Neher et al, 2001 124 Index of Concentration (CON) 22,38 GINI Index of Concentration (GINI)…”

Inequality in provider continuity for children by Australian general practitioners

“…However, it might be conjectured that the small, but constant, proportion of provider transience by GPs may have had a ripple effect on access in the ACT. One study in New Zealand has shown that the size of a general practice was influenced by word of mouth [17,18]. Parents might report on their experience of transient GPs to other parents who might then choose not to nominate that practice for their child.…”