Why does continuity of care with family doctors matter?

Nowak, D; Sheikhan, Natasha Y; Naidu, Sumana C.; Kuluski, Kerry; Upshur, Ross

doi:10.46747/cfp.6709679

Cited by 19 publications

(12 citation statements)

References 37 publications

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“…The patient-GP relationship was viewed as very important for the interviewees and they expressed fear that AI could influence the trust between them and the GP stating that people cannot trust a machine and that people must be critical towards AI. As mentioned previously the patient-GP relationship is emphasized as important in several other studies [9][10][11][12]. However, an Australian study considers that AI could be perceived as more ethical than a human GP, since it can be more effective, unbiased, and not prone to human fallibility.…”

Section: Discussionmentioning

confidence: 99%

“…Studies investigating America’s, the United Kingdom’s and the Dutch’s population views on AI in healthcare settings show similar results. Here, the patients believed that AI should be used as a support tool rather than a primary decision maker, which suggests that people are not interested in pursuing decision making pathways without a human involved [ 9 , 31 , 38 ]. The consensus that AI should not be the primary decision maker suggests that medical technologies are not perceived as being able to take the GPs’ place.…”

Section: Discussionmentioning

confidence: 99%

“…The GPs' role and status as primary physician and therefore a stable and relatable figure is widespread, and GPs are universally highly educated. However, in countries that face problems regarding access and availability to GPs, it is much harder for the patients to develop trust towards their GP, since the continuity and longevity of contact with the GP is a big part of creating the patient-GP relationship and the trust between them [9][10][11].…”

Section: Strengths and Limitationsmentioning

confidence: 99%

“…Some studies have shown that patients are more receptive to the use of AI if it is implemented and used in a way that preserves the patient-doctor relationship, partly due to fear of replacement of humans and partly because AI challenges the humanistic aspect of health care [ 7 , 8 ]. It has been suggested that the possibility for continuity and longevity of contact with the GP, along with the broad range of health-related concerns that people seek care for in general practice makes the patient-GP relationship particularly important in general practice [ 9 ]. It has been argued that to provide the patient with good care and effective encounters, there is a need for a healthy patient-GP relationship based on trust and good communication [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

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Patient perspectives on data sharing regarding implementing and using artificial intelligence in general practice – a qualitative study

Mikkelsen

Sørensen

Merrild

et al. 2023

BMC Health Serv Res

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Background Due to more elderly and patients with complex illnesses, there is an increasing pressure on the healthcare system. General practice especially feels this pressure as being the first point of contact for the patients. Developments in digitalization have undergone fast progress and data-driven artificial intelligence (AI) has shown great potential for use in general practice. To develop AI as a support tool for general practitioners (GPs), access to patients’ health data is needed, but patients have concerns regarding data sharing. Furthermore, studies show that trust is important regarding the patient-GP relationship, data sharing, and AI. The aim of this paper is to uncover patient perspectives on trust regarding the patient-GP relationship, data sharing and AI in general practice. Method This study investigated 10 patients’ perspectives through qualitative interviews and written vignettes were chosen to elicit the patients (interviewees) perspectives on topics that they were not familiar with prior to the interviews. The study specifically investigated perspectives on 1) The patient-GP relationship, 2) data sharing regarding developing AI for general practice, and 3) implementation and use of AI in general practice using thematic analysis. The study took place in the North Denmark Region and the interviewees included had to be registered in general practice and be above 18 years in age. We included four men between 25 to 74 years in age and six women between 27 to 46 years in age. Results The interviewees expressed a high level of trust towards their GP and were willing to share their health data with their GP. The interviewees believed that AI could be a great help to GPs if used as a support tool in general practice. However, it was important for the interviewees that the GP would still be the primary decision maker. Conclusion Patients may be willing to share health data to help implement and use AI in general practice. If AI is implemented in a way that preserves the patient-GP relationship and used as a support tool for the GP, our results indicate that patients may be positive towards the use of AI in general practice.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Strengths and Limitationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Patient perspectives on data sharing regarding implementing and using artificial intelligence in general practice – a qualitative study

Mikkelsen

Sørensen

Merrild

et al. 2023

BMC Health Serv Res

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show abstract

“…Measuring primary care‐focused continuity of care may present several advantages for practice physicians. These claims‐based measures may require less clerical work relative to existing measures and serve to reward what PCPs already value: namely longitudinal, trusting relationships with their patients 50,51 . Existing volume‐based incentives in the primary care setting emphasize patient access to care, leading to fuller physician schedules and, therefore, might work against continuity by overscheduling clinician time and making it hard for a given patient to see his or her own doctor 15,52,53 .…”

Section: Discussionmentioning

confidence: 99%

Physician‐ versus practice‐level primary care continuity and association with outcomes in Medicare beneficiaries

Yang¹,

Davis²,

Dai

et al. 2022

Health Services Research

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Objective: To compare physician-level versus practice-level primary care continuity and their association with expenditure and acute care utilization among Medicare beneficiaries and evaluate whether continuity of outpatient primary care at either/ both physician or/and practice level could be useful quality measures.Data Source: Medicare Fee-For-Service claims data for community dwelling beneficiaries without end-stage renal disease who were attributed to a national random sample of primary care practices billing Medicare (2011Medicare ( -2017.Study Design: Retrospective secondary data analysis at per Medicare beneficiary per year level. We used multivariable linear regression with practice-level fixed effects to estimate continuity of care score at physician versus practice level and their associations with outcomes.Data Collection/Extraction Method: We calculated clinician-and practice-level Bice-Boxerman continuity of care index scores, ranging from 0 to 1, using primary care outpatient claims. Medicare expenditures, hospital admissions, emergency department (ED) visits, and readmissions were obtained from the Medicare Beneficiary Summary File: Cost and Utilization Segment. Ambulatory care sensitive conditions (ACSC) were defined using diagnosis codes on inpatient claims.Principal Findings: We studied 2,359,400 beneficiaries who sought care from 13,926 physicians. Every 0.1 increase in physician continuity score was associated with a $151 reduction in expenditure per beneficiary per year (p < 0.01), and every 0.1 increase in practice continuity score was associated with $282 decrease (p < 0.01) per beneficiary per year. Both physician-and practice-level continuity were associated with lower Medicare expenditures among small, medium, and large practices.Both physician-and practice-level continuity were associated with lower probabilities of hospitalization, ED visit, admissions for ACSC, and readmission.Conclusions: Primary care continuity of care could serve as a potent value-based care quality metric. Physician-level continuity is a unique value center that cannot be supplanted by practice-level continuity.

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What’s after COVID-19?: Communication pathways influencing future use of telehealth

Wu,

Brannon

2024

Patient Education and Counseling

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Why does continuity of care with family doctors matter?

Cited by 19 publications

References 37 publications

Patient perspectives on data sharing regarding implementing and using artificial intelligence in general practice – a qualitative study

Patient perspectives on data sharing regarding implementing and using artificial intelligence in general practice – a qualitative study

Physician‐ versus practice‐level primary care continuity and association with outcomes in Medicare beneficiaries

What’s after COVID-19?: Communication pathways influencing future use of telehealth

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