How important is continuity of care?

As doctors working in a busy clinic alongside colleagues, we often encounter a number of patients whom we have never met before. Within the allocated time, we have to become rapidly acquainted with the patient’s previous history, develop a rapport and move on to address the patient’s present problems. The patient also has to quickly come to trust an unfamiliar face on the basis of their professional standing. One cannot but feel that if patients saw the same doctor at each clinic appointment, a better standard of care would result, along with a more satisfactory and effective consultation for both patient and doctor.

This sounds like common sense, and in these circumstances it is always interesting to know if there is an evidence base for the self evident. Is continuity of care important to professionals and to patients and, most important, is it clinically important? If it is, we should be making sure that our services take this into account.

EVIDENCE IN SUPPORT OF GOOD CONTINUITY OF CARE

Within the literature there has indeed been a focus on the importance of continuity of care. A number of studies have been carried out, principally in the area of general practice. Key studies in Norway showed that continuous care not only increased patient satisfaction but also allowed the doctor to accumulate knowledge that saved time, influenced their use of laboratory tests, allowed for expectant management, and to a lesser degree affected the use of medication.1,2 Patients were shown to value their relationship with their doctor more and felt they had more control over their health.2 Patients were not only more satisfied with the service, but the reduction in time and the more judicious use of investigations all improved the efficiency of the system. This was especially …