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Annals of Family Medicine 3:353-359 (2005)
© 2005 Annals of Family Medicine, Inc.
doi: 10.1370/afm.351
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Continuity of Care: Is the Personal Doctor Still Important? A Survey of General Practitioners and Family Physicians in England and Wales, the United States, and the Netherlands

Tim Stokes, PhD, MPH, MBChB1, Carolyn Tarrant, BSc1, Arch G. Mainous, III, PhD2, Henk Schers, MSc, MD3, George Freeman, MD4 and Richard Baker, MD1

1 Department of Health Sciences, University of Leicester, Leicester, UK
2 Department of Family Medicine,Medical University of South Carolina, Charleston, SC
3 Department of General Practice,University Medical Centre St Radboud, Nijmegen, The Netherlands
4 Centre for Primary Care and Social Medicine, Imperial College, London, UK

CORRESPONDING AUTHOR: Tim Stokes, PhD, Clinical Governance Research and Development Unit, Department of Health Sciences, Division of General Practice and Primary Health Care, University of Leicester, Leicester General Hospital, Leicester LE5 4PW tns2{at}le.ac.uk

PURPOSE We determined the reported value general practitioners/family physicians in 3 different health care systems place on the various types of continuity of care.

METHODS We conducted a postal questionnaire survey in England and Wales, the United States, and the Netherlands. The participants were 1,523 general practitioners/family physicians (568 from England and Wales, 453 from the United States and 502 from the Netherlands). Our main outcome measures were the perceived importance of the types of continuity of care and doctor or practice characteristics that may influence attitudes toward personal continuity of care.

RESULTS The response rates were England and Wales 60% (568/946), United States 47% (453/963) and Netherlands 76% (502/660). The doctors in all 3 countries felt strongly that personal continuity remained an important aspect of good-quality care to their patients. Within a given health care system, doctors’ personal and practice characteristics explained only a small part of the variance in attitudes toward the provision of personal continuity of care (England and Wales and the Netherlands r2 = 0.04, United States r2 = 0.01). The doctors in all 3 countries felt that they were currently able to provide all 3 types of continuity of care, although doctors in England and Wales were least positive about the provision of informational and management continuity across the primary-secondary care divide.

CONCLUSIONS General practitioners/family physicians from 3 differing health care systems all place high value on being able to provide personal continuity of care to patients. Personal continuity of care remains a core value of general practice/family medicine and should be taken account of by policy makers when redesigning health care systems.

Key Words: Continuity of care • physician-patient relations




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TRACK Comments:

Read all TRACK Comments

Continuity of care: What is this discussion really about?
Howard Tandeter
Annals of Family Medicine, 27 Jul 2005 [Full text]
continuity of care: a goal BEFORE redesigning health care systems
Manfred Maier
Annals of Family Medicine, 29 Jul 2005 [Full text]
Continuity of Care: The Best is Yet to Come
Joseph E. Scherger
Annals of Family Medicine, 29 Jul 2005 [Full text]
Interesting differences between US and England, Wales, and the Netherlands
Jennifer E Lochner
Annals of Family Medicine, 1 Aug 2005 [Full text]
Continuity of Care: Whom we need to involve ?
Waleed A. Albedaiwi
Annals of Family Medicine, 4 Aug 2005 [Full text]
Continuity of Care: Important for Whom?
David G Litaker, et al.
Annals of Family Medicine, 12 Aug 2005 [Full text]
Validation needed?
Greta Abella
Annals of Family Medicine, 30 Aug 2005 [Full text]
Trust and Personal Relationship with GP is Vital
Nancy A. Taylor
Annals of Family Medicine, 31 Aug 2005 [Full text]
Surprise at the original question.
John L.C. Daintree
Annals of Family Medicine, 31 Aug 2005 [Full text]
The role of Family Practitioners
Khalil Redah Al-Yousifi
Annals of Family Medicine, 3 Sep 2005 [Full text]
Re: The role of Family Practitioners
valluri ramarao
Annals of Family Medicine, 7 Sep 2005 [Full text]
Continuity of care
Stefano ALICE
Annals of Family Medicine, 23 Oct 2005 [Full text]

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