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Measuring continuity of care in general practice: a comparison of two methods using routinely collected data

Research output: Contribution to journalArticlepeer-review

Sally A Hull, Crystal Williams, Peter Schofield, Kambiz Boomla, Mark Ashworth

Original languageEnglish
Pages (from-to)e773-e779
JournalThe British journal of general practice : the journal of the Royal College of General Practitioners
Issue number724
Early online date22 Aug 2022
Accepted/In press29 Apr 2022
E-pub ahead of print22 Aug 2022
Published1 Nov 2022

Bibliographical note

Funding Information: The authors are grateful to the participating GPs for their cooperation, without which such studies would be impossible. The authors wish to thank staff at the Clinical Effectiveness Group (CEG) for supporting practices with guidance and data entry tools that support this project. Publisher Copyright: © The Authors.


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BackgroundDespite well-documented clinical benefits of longitudinal doctor-patient continuity in primary care, continuity rates have declined. Assessment by practices or health commissioners is rarely undertaken.AimUsing the Usual Provider of Care (UPC) score this study set out to measure continuity across 126 practices in the mobile, multi-ethnic population of East London, comparing these scores with the General Practice Patient Survey (GPPS) responses to questions on GP continuity.Design and settingA retrospective, cross-sectional study in all 126 practices in three East London boroughs.MethodThe study population included patients who consulted three or more times between January 2017 and December 2018. Anonymised demographic and consultation data from the electronic health record were linked to results from Question 10 ('seeing the doctor you prefer') of the 2019 GPPS.ResultsThe mean UPC score for all 126 practices was 0.52 (range 0.32 to 0.93). There was a strong correlation between practice UPC scores measured in the 2 years to December 2018 and responses to the 2019 GPPS Question 10, Pearson's r correlation coefficient, 0.62. Smaller practices had higher scores. Multilevel analysis showed higher continuity for patients ≥65 years compared with children and younger adults (β coefficient 0.082, 95% confidence interval = 0.080 to 0.084) and for females compared with males.ConclusionIt is possible to measure continuity across all practices in a local health economy. Regular review of practice continuity rates can be used to support efforts to increase continuity within practice teams. In turn this is likely to have a positive effect on clinical outcomes and on satisfaction for both patients and doctors.

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