Personal GP continuity improves healthcare outcomes in primary care populations: a systematic review.

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.

Method: Embase, PubMed, Scopus, and Web of Science were searched for studies published between 1 January 2000 and 31 October 2023. Owing to study heterogeneity the synthesis was conducted narratively; study results were summarised and expressed as having higher (compared with lower) continuity of care. Certainty of each summarised result was assessed using the GRADE framework.

Results: Out of 5792 unique references, 18 studies were included in the final analyses. The outcomes were grouped into three categories of summarised outcomes. Higher (when compared with lower) personal continuity with a GP/family physician probably prevents premature mortality (moderate certainty: four studies, 5 638 305 participants), probably reduces the risk of admission to hospital (moderate certainty: 11 studies, 13 642 684 participants), and probably lowers risk of emergency department visits (moderate certainty: seven studies, 3 855 487 participants).

Conclusion: Higher, compared with lower, continuity in the relationship between GP and patients in primary care populations is associated with reduced mortality, admissions to hospital, and emergency department visits. Relatively small improvements in personal continuity, which may be achieved in most practices, significantly reduce healthcare consumption, and thus may have an impact on access to care, which has implications for healthcare policy.