Continuity index


Isaac Barker et el in the BMJ Feb 2017 applied a usual provider of care index as a ratios with 1 as maximum continuity. It was defined as the proportion of contacts occurring that were with the most frequently seen general practitioner. This can be read at:

Number of times seen
Number of times seen by the same person
For that problem

If continuity of care contributes to quality of care we ought to consider what aspects are important and how we might measure them.

Measurement is not to reduce it to irrelevant components, but to allow research into whether continuity contributes to the quality of medical care and which elements of continuity contribute most.

There is little literature on this subject and the current best summary is the Kings Fund report “Continuity of Care and the Patient Experience” by Professor George Freeman and Jane Hughes.

It is that proactive follow up of the presenting and incidental problems. Does that doctor actively cover all the issues, produce adequate records, note follow up arrangements, check any blood results and see through any planned actions

On a very simplistic basis we could just consider:

Number of times seen for the same problem

Divided by

Number of times seen by the same general practitioner for that problem

A score of two or more might  be better

A score of less than one might indicate a need to look at examples and if a change in approach is needed

This is an area of development and the proposals here are to encourage debate rather than as a definitive answer