Enabling patient-physician continuity in Swedish primary care: the importance of a named GP.

Abstract

Background: Continuity of care is important for patients with chronic conditions. Assigning patients to a named GP may increase continuity.

Aim: To examine if patients who were registered with a named GP at the onset of their first chronic disease had higher continuity at subsequent visits than patients who were only registered at a practice.

Design & setting: Registry-based observational study in Region Skåne, Sweden. The study population included 66,063 patients registered at the same practice at least 1 year before the first chronic condition onset in 2009-2015.

Method: We compared patients registered with a named GP with patients only registered at a practice over a four-year follow-up period. The primary outcome was the Usual Provider of Care (UPC) index, for all visits and for visits related to the chronic disease. Secondary outcomes were the number of GP, nurse and out-of-hours visits, ED visits, hospital admissions, and mortality. We used linear regression models, adjusted for patient characteristics (using entropy balancing weights) and for practice-level fixed effects.

Results: Patients with a named GP at onset had 3-4 percentage points higher UPC, but the difference decreased and was not statistically significant after adjusting for patient and practice characteristics. Patients with a named GP made more visits, though not for the chronic condition. There were no statistically significant differences for the other outcomes.

Conclusion: Registration with a GP at onset does not imply higher continuity at visits and is not linked to other relevant outcomes for patients diagnosed with their first chronic condition.