General practice and patient characteristics associated with personal continuity: a mixed-methods study.

Personal continuity of care is a core value of general practice. It is increasingly threatened by societal and healthcare changes. To investigate the association between personal continuity and both practice and patient characteristics; and to incorporate GPs' views to enrich and validate the quantitative findings. A mixed-methods study based on observational, routinely collected healthcare data from 269 478 patients from 48 Dutch general practices (2013-2018) and interviews with selected GPs. First, four different personal continuity outcome measures were calculated relating to eight practice and 12 patient characteristics using multilevel linear regression analyses. Second, a thematic analysis was performed of semi-structured interviews with 10 GPs to include their views on factors contributing to personal (dis) continuity. These GPs worked at the 10 practices with the largest difference between calculated and model-estimated personal continuity. Both a larger number of usual GPs working in a practice and a larger percentage of patient contacts with locum GPs were dose-dependently associated with lower personal continuity (highest versus lowest quartile -0.094 and -0.092, respectively, P<0.001), whereas days since registration with the general practice was dose-dependently associated with higher personal continuity (highest versus lowest quartile +0.017, P<0.001). Older age, number of chronic conditions, and contacts were also associated with higher personal continuity. The in-depth interviews identified three key themes affecting personal continuity: team composition, practice organisation, and the personal views of the GPs. Personal continuity is associated with practice and patient characteristics. The dose-dependent associations suggest a causal relationship and, complemented by GPs' views, may provide practical targets to improve personal continuity directly.

Winkel MTT ，Slottje P ，de Kruif AJ ，Lissenberg-Witte BI ，van Marum RJ ，Schers HJ ，Uijen AA ，Bont J ，Maarsingh OR ... -  《-》

Personal continuity and access in UK general practice: a qualitative study of general practitioners' and patients' perceptions of when and how they matter.

Guthrie B ，Wyke S 《BMC Family Practice》

Optimising personal continuity: a survey of GPs' and older patients' views.

Personal continuity - having a GP who knows their patients and keeps track of them - is an important dimension of continuity of care and is associated with lower mortality rates, higher quality of life, and reduced healthcare costs. In recent decades it has become more challenging for GPs to provide personal continuity owing to changes in society and health care. To investigate GPs' and older patients' views on personal continuity and how personal continuity can be improved. Cross sectional survey study in The Netherlands. A digital and postal survey was sent to 499 GPs and 1599 patients aged 65 years or older. Results were analysed using descriptive statistics for quantitative data and thematic analysis for open questions. In total, 249 GPs and 582 patients completed the surveys. A large majority of GPs (92-99%) and patients (91-98%) felt it was important for patients to see their own GP for life events or psychosocial issues. GPs and patients provided suggestions on how personal continuity can be improved. The thematic analysis of these suggestions identified nine themes: 1) personal connection, 2) GP accessibility and availability, 3) communication about (dis)continuity, 4) GP responsibility, 5) triage, 6) time for the patient, 7) actions by third parties, 8) team continuity, and 9) GP vocational training. Both GPs and older patients still place high value on personal continuity in the context of a changing society. GPs and patients provided a wide range of suggestions for improving personal continuity. The authors will use these suggestions to develop interventions for optimising personal continuity in general practice.

Groot L ，Te Winkel M ，Schers H ，Burgers J ，Smalbrugge M ，Uijen A ，van der Horst H ，Maarsingh O ... -  《-》

UK GPs' and practice nurses' views of continuity of care for patients with type 2 diabetes.

Alazri MH ，Heywood P ，Neal RD ，Leese B ... -  《FAMILY PRACTICE》

'Two sides of the coin'--the value of personal continuity to GPs: a qualitative interview study.

Ridd M ，Shaw A ，Salisbury C 《FAMILY PRACTICE》