The continuity of care in primary care is associated with a more favorable prognosis in patients referred to a cardiology service.

Abstract

Introduction and objectives To analyze the relationship between continuity of care in primary care and hospitalizations and mortality among patients referred from primary care to a cardiology service. Methods Continuity of care was assessed using 3 measures: a) whether the referral was made by the patient's regular family medicine physician (FMP) or a different FMP, b) FMP turnover within a patient panel, and c) turnover of the referring FMP among different patient panels. The association between continuity of care and hospitalizations and mortality was assessed using a multivariate analysis, with adjustment for potential confounding variables. The results are expressed as odds ratios (OR) with 95% confidence intervals (95%CI). Results A total of 67 889 patients, referred from 2010 to 2023, were included, of whom 80.5% were referred by their FMP. Patients referred by an FMP other than their own had a higher annual referral rate (2.3 [2.9]) vs 1.5 [0.6]); P < .001) and were assigned to panels with a higher referral rate (10.5 [12.7] vs 1.6 (1.1]; P < .001). Patients referred by their FMP had a lower risk of overall hospitalizations (OR, 0.90; 95%CI, 0.86-0.94), hospitalizations for cardiovascular causes (OR, 0.88; 95%IC, 0.82-0.95), all-cause mortality (OR, 0.84; 95%CI, 0.80-0.89), cardiovascular-related mortality (OR, 0.86; 95%CI, 0.78-0.96), and heart failure-related mortality (OR, 0.77; 95%CI, 0.66-0.89). Conclusions Continuity of care, measured by the persistence of the FMP within the same patient panel, improves health outcomes by reducing hospitalizations and mortality, as well as the number of cardiology service referrals. Full English text available from: www.revespcardiol.org/en.