What do we know about patients' perceptions of continuity of care? A meta-synthesis of qualitative studies
Open Access
- 6 December 2011
- journal article
- research article
- Published by Oxford University Press (OUP) in International Journal for Quality in Health Care
- Vol. 24 (1), 39-48
- https://doi.org/10.1093/intqhc/mzr068
Abstract
ObjectiveThe increasing complexity in healthcare delivery might impede the achievement of continuity of care, being defined as ‘one patient experiencing care over time as coherent and linked’. This article aims to improve the knowledge on patients' perceptions of relational (RC), informational (IC) and management continuity (MC) across care levels.DesignA descriptive, qualitative meta-synthesis was conducted based on a literature search in various electronic databases using the subject heading ‘continuity of care’ and linked key terms. We scanned retrieved articles for adherence to inclusion criteria: (i) relevance to research topic, (ii) original study adopting a qualitative design and (iii) investigating the patient's perspective. Content analysis was conducted by identification of themes and aggregation of findings.ResultsThe selected 25 studies most frequently investigated RC. Being attended to regularly and over time by one physician (RC) was valued by chronic ill patients, but balanced with convenient access by young patients (MC). Communication and information transfer across care settings as well as the gathering of holistic information about the patient were perceived to foster IC. Critical features for achieving MC were accessibility between care levels, individualized care and a smooth discharge process including the receipt of support. Patients further considered that their personal involvement was one facilitating element of continuity of care.ConclusionsPatients identified elements that enhance or distract from continuity of care across boundaries. Variations in perceived importance seem to depend on both individual and contextual factors which should be taken into account during healthcare provision.Keywords
This publication has 32 references indexed in Scilit:
- Older persons’ experiences of whole systems: the impact of health and social care organizational structuresJournal of Nursing Management, 2008
- Understanding how clinician-patient relationships and relational continuity of care affect recovery from serious mental illness: STARS study results.Psychiatric Rehabilitation Journal, 2008
- Quality in general practice consultations; a qualitative study of the views of patients living in an area of high socio-economic deprivation in ScotlandBMC Family Practice, 2007
- Patients' views on interpersonal continuity in primary care: a sense of security based on four core foundationsFamily Practice, 2005
- Meta‐synthesis method for qualitative research: a literature reviewJournal of Advanced Nursing, 2005
- Interpersonal Continuity of Care and Patient Satisfaction: A Critical ReviewAnnals of Family Medicine, 2004
- Patients with comorbidities: perceptions of acute care servicesJournal of Advanced Nursing, 2004
- What is important to continuity in home care?: Perspectives of key stakeholdersSocial Science & Medicine (1982), 2004
- Continuity of care: a multidisciplinary reviewBMJ, 2003
- Qualitative research in health care: Assessing quality in qualitative researchBMJ, 2000