Older patients who see the same general practitioner over time experience fewer avoidable admissions to hospital for certain conditions. These are the findings of a new study published by The BMJ.
Healthcare systems in many countries are seeking to reduce hospital admissions for patients with conditions manageable in primary care (i.e. without hospital admission). Emergency admissions for these conditions accounted for £1.42bn of spending in England (£170,590 for each general practice) in 2009-10.
In recent years, focus has largely been on improving access to primary care (for example, by extending opening hours or introducing remote care), but this might have the unintended effect of reducing continuity of care.
In fact, evidence suggests that continuity of care is declining in England – and its link with hospital admissions has been unclear. So researchers at The Health Foundation examined whether continuity of care with a general practitioner is associated with hospital admissions for ambulatory care sensitive conditions for older patients.
They analysed patient level data from English primary and secondary care records for over 230,000 patients aged between 62 and 82 years between April 2011 and March 2013. They chose to focus on older patients because they account for a high proportion of both GP consultations and potentially avoidable hospital admissions.
They found that continuity of care varied considerably across general practices in England, and tended to be lower in larger practices. Patients who saw the same general practitioner a greater proportion of the time experienced fewer admissions to hospital for ambulatory care sensitive conditions than other patients.