Patients’ perceptions and experiences of ‘continuity of care’ in diabetes
Open Access
- 8 May 2006
- journal article
- Published by Wiley in Health Expectations
- Vol. 9 (2), 118-129
- https://doi.org/10.1111/j.1369-7625.2006.00379.x
Abstract
Background ‘Continuity of care’ is an important aspect of quality. However, definitions are broad and existing models of continuity are not well grounded in empirical data. Objective To identify patients’ experiences and values with respect to continuity in diabetes care. Methods In‐depth semi‐structured interviews with 25 type 2 diabetic patients from 14 general practices in two inner London boroughs. Interviews were transcribed and responses analysed thematically and grouped into dimensions of continuity of care. Results Patients’ accounts identified aspects of care they valued that were consistent with four dimensions of experienced continuity of care. These were receiving regular reviews with clinical testing and provision of advice over time (longitudinal continuity); having a relationship with a usual care provider who knew and understood them, was concerned and interested, and took time to listen and explain (relational continuity); flexibility of service provision in response to changing needs or situations (flexible continuity); and consistency and co‐ordination between different members of staff, and between hospital and general practice or community settings (team and cross‐boundary continuity). Problems of a lack of experienced continuity mainly occurred at transitions between sites of care, between providers, or with major changes in patients’ needs. Conclusions The study develops a patient‐based framework for assessing continuity of care in chronic disease management and identifies key transition points with problems of lack of continuity. It is important that service ‘redesign’ and developments in vertically integrated services for chronic disease management take account of impacts on patients’ experience of continuity of care.Keywords
This publication has 26 references indexed in Scilit:
- What do patients and the public want from primary care?BMJ, 2005
- Competition in general practiceBMJ, 2005
- Interpersonal Continuity of Care and Care Outcomes: A Critical ReviewAnnals of Family Medicine, 2005
- Interpersonal Continuity of Care and Patient Satisfaction: A Critical ReviewAnnals of Family Medicine, 2004
- Continuity of care: a multidisciplinary reviewBMJ, 2003
- Continuity of Care: Process or Outcome?Annals of Family Medicine, 2003
- Qualitative study of the meaning of personal care in general practiceBMJ, 2003
- Human resources policies and continuity of careJournal of Health Organization and Management, 2003
- What does a Human Relationship with the Doctor mean?Scandinavian Journal of Primary Health Care, 1992
- A Quantitative Measure of Continuity of CareMedical Care, 1977