Abstract Body

Background and purpose

Continuity of care has many benefits, including a better patient-doctor relationship, prevention of hospital admission, reduced health care costs, better medication compliance, and lower mortality rates.

The aim of this study is to investigate the association between personal continuity and general practice characteristics, and to identify additional factors associated with personal continuity.

Methods

Observational study of 4.7 million contacts of 190.886 patients from 48 different general practices in 2013-2018 in the Netherlands. Personal continuity was calculated using four established measures (Usual Provider Continuity; Bice-Boxerman Continuity of Care Index; Herfindahl Index; Modified Modified Continuity Index). Linear mixed models were used to determine the association between continuity level and practice characteristics, adjusted for patient characteristics. In order to identify additional factors associated with personal continuity, we conducted interviews with general practitioners working in practices with the largest difference between observed and predicted continuity.

Results

We identified nine practice characteristics that were significantly associated with continuity of care (p<0.05). Of these characteristics, six were significant in all models: number of registered patients; number of doctors and their working days; number of locums and their percentage of contacts; number of other employees. These effects were adjusted for patient characteristics, including type of contacts, age, sex, medical history, time of registration, and ancestry (p<0.05). Interviews may provide insights in additional factors (analyses will be completed).

Conclusions

Six characteristics were associated with higher continuity of care, which can be calculated using general practice data. Optimization of these characteristics may contribute to improving personal continuity.