References for Continuity of Care Impact

When they receive continuity of doctor care, patients:

Are more satisfied * Baker and Streatfield (1995)

Baker et al (2003)

Adler et al (2010)

Are more likely to follow medical advice (adherence) Warren et al (2015)​

Chen et al (2013)​

Are more likely to take up offers of personal preventive medicine O’Malley et al (1997)​

Christiakis et al (2003)​

Are more likely to have a good doctor patient relationship with their GP Mainous et al (2001)​

Ridd et al (2011)  ​

Are more likely to receive good quality of care O’Connor et al (1998)​

Romano and Segal (2015)​

Are less likely to need to go to A&E * Brousseau  et al (2004)​

Van den Berg et al (2016)

Are less likely to need a hospital admission, ** particularly for ambulatory care sensitive conditions Barker et al (2017)​

Bankart et al (2011)​

Are likely to live longer* Maarsingh et al (2016)​

Pereira Gray et al (2018)​

Have more cost effective healthcare (including meaning funding available for other things) Starfield (1994)​

Weiss and Blustein (1996)​

When continuity of doctor care is provided, doctors:

Have an ‘accumulated knowledge’ about the patient.  Doctors use such accumulated knowledge both for diagnosis and to tailor their advice. Hjortdahl & Borchgrevink (1991)

Hjortdahl (1992)

Ridd et al (2011)

Report that continuity enables them to provide a ‘higher-quality’ care. GPs are then rewarded with more professional satisfaction through doing a better job. Ridd, Shaw, & Salisbury (2006)​
Have improved problem recognition and quality of management for long term conditions Saultz and Lochner (2005)​

Baird et al (2018​)

Have reduced conflicts of responsibility , particularly reducing the ‘collusion of anonymity’ where succession of clinicians only deal with what is immediately most pressing Freeman and Hughes (2010)​
Contribute to the reduced the use of specialist care, A&E, emergency admissions and outpatient appointments* Hansen et al (2013)​

Katz et al (2015​)

Reduce costs e.g. prescriptions and tests Weiss and Blustein (1996)​

Saultz and Lochner (2005)​

Reduce cases of avoidable significant harm Avery et al (2020)

A good introduction to continuity is shared by Sir Denis Pereira Gray in the Improving Continuity: The Clinical Challenge (2016