Continuity in general practice as a predictor of mortality, acute hospitalization, and use of out-of-hours services: registry-based observational study in Norway

112Citations
Citations of this article
151Readers
Mendeley users who have this article in their library.

Abstract

Background Continuity, usually considered a quality aspect of primary care, is under pressure. Aim To analyse the association between longitudinal continuity with a named regular general practitioner (RGP) and use of out-of-hours (OOH) services, acute hospitalization, and mortality. Design and setting Registry-based observational study in Norway covering 4 552 978 Norwegians listed with their RGPs. Method Duration of RGP-patient relationship was used as explanatory variable for the use of OOH services, acute hospitalization, and mortality in 2018. Several patient-related and RGP-related covariates were included in the analyses by individual linking to high-quality national registries. Duration of RGP-patient relationship was categorized as 1, 2–3, 4–5, 6–10, 11–15, and > 15 years. Results are given as adjusted odds ratio (OR) with 95 % confidence interval resulting from multilevel logistic regression analyses. Results Compared with a one-year RGP-patient relationship the OR for use of OOH services decreased gradually from 0.87 (0.86 – 0.88) after 2 – 3 years duration to 0.70 (0.69 – 0.71) after more than 15 years. OR for acute hospitalization decreased gradually from 0.88 (0.86 – 0.90) after 2 – 3 years duration to 0.72 (0.70 – 0.73) after more than 15 years. OR for dying decreased gradually from 0.92 (0.86 – 0.98) after 2 – 3 years duration to 0.75 (0.70 – 0.80) after an RGP-patient relationship of more than 15 years. Conclusion Length of RGP-patient relationship is significantly associated with lower use of out-of-hours services, fewer acute hospitalizations, and lower mortality. The associations are dose-dependent and probably causative.

Cite

CITATION STYLE

APA

Sandvik, H., Hetlevik, Ø., Blinkenberg, J., & Hunskaar, S. (2022). Continuity in general practice as a predictor of mortality, acute hospitalization, and use of out-of-hours services: registry-based observational study in Norway. British Journal of General Practice, 72(715). https://doi.org/10.3399/BJGP.2021.0340

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Save time finding and organizing research with Mendeley

Sign up for free