This study aims to examine how continuity of care between GPs and their patients has changed over the past 15 years. Being able to see a doctor who knows them well is important to many patients however there are worries that the quality of doctor-patient relationship has been put under pressure by changes in how general practice is delivered. Despite the importance of continuity of care in primary care there are no published studies using data from medical records that look at how much continuity of care has changed. A better understanding of if and how much continuity of care has declined and for which patient groups can help policy makers and GP surgeries decide how much they should prioritise improving continuity of care.
This study is a longitudinal study of trends in continuity of care in English general practice. It aims to quantify how levels of interpersonal continuity of care between GPs and patients have changed over a decade and the extent that such changes can be explained by changes in patient population characteristics. It also aims to identify whether trends differ substantially: a) for patients of different characteristics (over/under 75 years and with/without multiple morbidities); and b) between practices.
Consultation data from a two-stage cluster random sample of patients in practices will be analysed using multilevel regression models to explore changes in three measures of continuity of care. Variance in continuity of care slopes between practices will be compared to within patient level variation as a way of interpreting the scale of between practice variance. Results will help identify whether practice-level variation in case-mix adjusted continuity rates exist, suggesting the possibility of practice-modifiable effects that may be the target for further research and policy action.
Anas El Turabi - Chief Investigator - University of Cambridge
Martin Roland - Collaborator - University of Cambridge
Patient Level Index of Multiple Deprivation