Programme no. 542-OP
Quality Improvement
Continuity of primary care is best supported by the availability of a specific doctor appointed for patients: a comparative study of Finnish municipalities in 2011 and 2103
Risto Raivio*1, Kari Mattila2, Doris Holmberg-Marttila3
1Primary Health Care Unit ,Joint Authority for Päijät-Häme Social and Health Care Group,15830 Lahti,Finland, 2School of Medicine, Department of General Practice,University of Tampere,Tampere,Finland, 3Centre for General Practice, Pirkanmaa Hospital District,Tampere,Finland
* = Presenting author
Objectives: The aim here was to find out if larger population, lower morbidity rate or better affluence of the municipality could bring better continuity for the patients. We also assessed the relationship between a specific doctor appointed for a patient and the possible variation of the continuity in the municipalities.
Background: Continuity is a basic principle and an essential part of high quality primary care. We here assessed patient-related continuity of care in primary health care centres in the Tampere University Hospital catchment area in Finland. We also examined the differences in indicators of municipalities and population in that area, and the relationship between the indicators and the continuity of care.
Results: The continuity of care varied considerably among the municipalities. The highest percentage for continuity of care was 95% and the poorest 0%. None of the indicators describing the municipalities explained the differences between them. If there was a particularly assigned doctor for the patients in the municipality the continuity was significantly more likely (OR 26.1, p<0.001) than in municipalities with no specific doctor appointed for patients. The relationship was notably lower (OR 5.0, p=0.022) between the lack of doctors and the continuity of care.
Material/Methods: We conducted a follow-up questionnaire survey among patients attending the Tampere University Hospital catchment area health care centres in 2011 and 2013. Continuity was assessed with the question: “When visiting the health centre, do you usually see the same doctor?” The indicators describing the municipalities and population were collected from 2011 data from Statistics of Finland, the Association of Finnish Local and Regional Authorities, the National Institute for Health and Welfare and the Social Insurance Institution of Finland.
Conclusion: The population, the morbidity rate and the affluence of the municipality did not explain the variation in continuity of care between the municipalities. Regardless of differences between municipalities and population, the availability of a specific doctor appointed for patients would appear to support best the continuity of care.
Points for discussion:
  1. What does it mean for a patient to have and for a GP to be a specific doctor appointed for a patient?
  2. How can the authorities ensure the continuity of care for at least those patients who need the care most?