Skip to main content
The British Journal of General Practice logoLink to The British Journal of General Practice
. 2002 Jun;52(479):459–462.

Continuity of care in general practice: a survey of patients' views.

Henk Schers 1, Sophie Webster 1, Henk van den Hoogen 1, Anthony Avery 1, Richard Grol 1, Wil van den Bosch 1
PMCID: PMC1314320  PMID: 12051209

Abstract

BACKGROUND: It is not known how patients value continuity for different health problems. In addition, it is not clear how different types of patients value continuity. It has been argued, for example, that young and healthy individuals have different ideas about continuity from older people with chronic illnesses. More extensive exploration of patients' views and expectations on personal continuity is important as this may help to organise general practice better in the future. AIM: To explore patients' views on continuity of care in general practice and their relations to patient characteristics. DESIGN OF STUDY: Postal questionnaire survey. SETTING: Thirty-five general practices throughout The Netherlands. METHOD: A sample of 25 patients from each practice was sent a questionnaire. RESULTS: The response rate was 644/875 (74%). The percentage of patients feeling that it was important to see their personal doctor varied, from 21% for a splinter in the eye, to 96% for discussing the future when seriousy ill. The main reasons for preference of their own general practitioners (GPs) were the GP's assumed better medical knowledge of the patient and understanding of the personal and family background. Multiple linear regression analysis (GLM) showed that patient characteristics could explain 10% to 12% of the variance in these views on personal continuity. CONCLUSION: The importance that patients attach to continuity of care depends on the seriousness of the conditions/facing them. Patients in The Netherlands desire a high level of personal care for serious conditions. Patient characteristics, such as age, sex, and frequency of visits to the GP influence views on continuity of care only to a minor extent.

Full Text

The Full Text of this article is available as a PDF (170.4 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Di Blasi Z., Harkness E., Ernst E., Georgiou A., Kleijnen J. Influence of context effects on health outcomes: a systematic review. Lancet. 2001 Mar 10;357(9258):757–762. doi: 10.1016/s0140-6736(00)04169-6. [DOI] [PubMed] [Google Scholar]
  2. Dixon D. M., Sweeney K. G., Gray D. J. The physician healer: ancient magic or modern science? Br J Gen Pract. 1999 Apr;49(441):309–312. [PMC free article] [PubMed] [Google Scholar]
  3. Fletcher R. H., O'Malley M. S., Earp J. A., Littleton T. A., Fletcher S. W., Greganti M. A., Davidson R. A., Taylor J. Patients' priorities for medical care. Med Care. 1983 Feb;21(2):234–242. doi: 10.1097/00005650-198302000-00010. [DOI] [PubMed] [Google Scholar]
  4. Freeman G. Priority given by doctors to continuity of care. J R Coll Gen Pract. 1985 Sep;35(278):423–426. [PMC free article] [PubMed] [Google Scholar]
  5. Guthrie B., Wyke S. Does continuity in general practice really matter? BMJ. 2000 Sep 23;321(7263):734–736. doi: 10.1136/bmj.321.7263.734. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Hagman E., Rehnström T. Priorities in primary health care. The views of patients, politicians and health care professionals. Scand J Prim Health Care. 1985 Nov;3(4):197–200. doi: 10.3109/02813438509013949. [DOI] [PubMed] [Google Scholar]
  7. Hall J. A., Dornan M. C. What patients like about their medical care and how often they are asked: a meta-analysis of the satisfaction literature. Soc Sci Med. 1988;27(9):935–939. doi: 10.1016/0277-9536(88)90284-5. [DOI] [PubMed] [Google Scholar]
  8. Hjortdahl P., Borchgrevink C. F. Continuity of care: influence of general practitioners' knowledge about their patients on use of resources in consultations. BMJ. 1991 Nov 9;303(6811):1181–1184. doi: 10.1136/bmj.303.6811.1181. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Hjortdahl P., Laerum E. Continuity of care in general practice: effect on patient satisfaction. BMJ. 1992 May 16;304(6837):1287–1290. doi: 10.1136/bmj.304.6837.1287. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Howie J. G., Heaney D. J., Maxwell M., Walker J. J., Freeman G. K., Rai H. Quality at general practice consultations: cross sectional survey. BMJ. 1999 Sep 18;319(7212):738–743. doi: 10.1136/bmj.319.7212.738. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Jung H. P., Wensing M., Grol R. What makes a good general practitioner: do patients and doctors have different views? Br J Gen Pract. 1997 Dec;47(425):805–809. [PMC free article] [PubMed] [Google Scholar]
  12. Kearley K. E., Freeman G. K., Heath A. An exploration of the value of the personal doctor-patient relationship in general practice. Br J Gen Pract. 2001 Sep;51(470):712–718. [PMC free article] [PubMed] [Google Scholar]
  13. Lydeard S. The questionnaire as a research tool. Fam Pract. 1991 Mar;8(1):84–91. doi: 10.1093/fampra/8.1.84. [DOI] [PubMed] [Google Scholar]
  14. Mainous A. G., 3rd, Baker R., Love M. M., Gray D. P., Gill J. M. Continuity of care and trust in one's physician: evidence from primary care in the United States and the United Kingdom. Fam Med. 2001 Jan;33(1):22–27. [PubMed] [Google Scholar]
  15. McWhinney I. R. Primary care: core values. Core values in a changing world. BMJ. 1998 Jun 13;316(7147):1807–1809. doi: 10.1136/bmj.316.7147.1807. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Murphy A. W. Opening Pandora's box: patients' attitudes towards trainees. Dublin General Practice Vocational Training Scheme Third Year Group 1991-1992. Fam Pract. 1995 Sep;12(3):318–323. doi: 10.1093/fampra/12.3.318. [DOI] [PubMed] [Google Scholar]
  17. Neuberger J. Primary care: core values. Patients' priorities. BMJ. 1998 Jul 25;317(7153):260–262. doi: 10.1136/bmj.317.7153.260. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Schuman J. S. A study of family practice in New York City. J Fam Pract. 1983 Jun;16(6):1125–1129. [PubMed] [Google Scholar]
  19. Stone D. H. Design a questionnaire. BMJ. 1993 Nov 13;307(6914):1264–1266. doi: 10.1136/bmj.307.6914.1264. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Taylor M. B. Compassion: its neglect and importance. Br J Gen Pract. 1997 Aug;47(421):521–523. [PMC free article] [PubMed] [Google Scholar]
  21. Uhlmann R. F., Inui T. S., Carter W. B. Patient requests and expectations. Definitions and clinical applications. Med Care. 1984 Jul;22(7):681–685. doi: 10.1097/00005650-198407000-00011. [DOI] [PubMed] [Google Scholar]
  22. Wensing M., Jung H. P., Mainz J., Olesen F., Grol R. A systematic review of the literature on patient priorities for general practice care. Part 1: Description of the research domain. Soc Sci Med. 1998 Nov;47(10):1573–1588. doi: 10.1016/s0277-9536(98)00222-6. [DOI] [PubMed] [Google Scholar]

Articles from The British Journal of General Practice are provided here courtesy of Royal College of General Practitioners

RESOURCES