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Pioneering study finds continuity of care is ‘matter of life and death’

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Continuity of care by clinicians is associated with lower patient mortality, according to UK researchers.

Their ground-breaking study has concluded that patients who see the same GP over time have lower death rates.

“Patients across cultural boundaries appear to benefit from continuity of care”

Study authors

The researchers, from Devon, said their findings revealed the importance of “interpersonal factors” surrounding clinicians and patients, despite ongoing technical advances in healthcare.

The study is the first ever systematic review of the relationship between death rates and continuity of care. It is a collaboration between the University of Exeter Medical School and the St Leonard’s Practice, which is also located in the centre of the city and has around 10,000 patients.

The study, published this week in the journal BMJ Open, analysed all the available evidence in the field to draw its conclusions, looking at over 700 research papers in total.

The researchers then analysed the results of 22 eligible “high-quality” studies with varying time frames. The studies were from nine countries with very different cultures and health systems.

Of those, 82% found that repeated contact with the same doctor over time meant significantly fewer deaths over the study periods, compared with those without continuity.

“The human aspect of medical practice has been neglected. Our study shows it is potentially life-saving” 

Philip Evans

The effect applied across different cultures, and was true not just for doctors in primary care, but for specialists including psychiatrists and surgeons as well.

The study authors said: “This first systematic review reveals that increased continuity of care by doctors is associated with lower mortality rates.

“Although all the evidence is observational, patients across cultural boundaries appear to benefit from continuity of care with both generalist and specialist doctors,” they said.

They added: “Despite substantial, successive, technical advances in medicine, interpersonal factors remain important.”

Lead author Sir Denis Pereira Gray, from the St Leonard’s Practice, said: “Patients have long known that it matters which doctor they see and how well they can communicate with them.

“Until now arranging for patients to see the doctor of their choice has been considered a matter of convenience or courtesy,” he noted.

“Now it is clear it is about the quality of medical practice and is literally ‘a matter of life and death’,” said Sir Denis, who is a former president of the Royal College of General Practitioners.

Senior study author Professor Philip Evans, from Exeter University, said continuity of care lead to better communication, patient satisfaction, adherence to advice and lower use of hospital services.

“As medical technology and new treatments dominate the medical news, the human aspect of medical practice has been neglected,” he said. “Our study shows it is potentially life-saving and should be prioritised.”

 

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