Personal GP-continuity improves healthcare outcomes in primary care populations - A systematic review.

Abstract

Background Personal continuity is a hallmark for GPs but there is insufficient evidence to support its benefits in ordinary primary-care populations. Aim To investigate the effects of GP- personal continuity on the healthcare outcomes of primary-care populations. Design and Setting Systematic review of quantitative studies investigating associations between personal continuity of care and outcomes such as mortality and healthcare utilisation. Methods Embase, PubMed, Scopus, and Web of Science were searched for studies published between January 1, 2000 and October 31, 2023. Due to study heterogeneity the synthesis was conducted narratively; study results were summarised, and expressed as having higher (compared to lower) continuity of care. Certainty of each summarised result was assessed using the GRADE framework. Results Out of 5 792 unique references 18 studies were included in the final analyses. The outcomes were grouped into three categories of summarised outcomes. Higher (when compared to lower) personal continuity with a GP/FP probably prevents premature mortality (moderate certainty: 4 studies, 5 638 305 participants), probably reduces the risk of hospitalisation (moderate certainty: 11 studies, 13 642 684 participants) and probably lowers risk of emergency-department visits (moderate certainty: 7 studies, 3 885 487 participants). Conclusion Higher, compared to lower, continuity in the relationship between GP and patients in primary care populations is associated with reduced mortality, hospitalisation, and emergency-department visits. Relatively small improvements in personal continuity, that may be achieved in most practices, significantly reduce healthcare consumption, and thus influence the access to care, which have implications for healthcare policy.