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Review ArticleSystematic Reviews

Experienced Continuity of Care When Patients See Multiple Clinicians: A Qualitative Metasummary

Jeannie L. Haggerty, Danièle Roberge, George K. Freeman and Christine Beaulieu
The Annals of Family Medicine May 2013, 11 (3) 262-271; DOI: https://doi.org/10.1370/afm.1499
Jeannie L. Haggerty
1Department of Family Medicine, McGill University, Canada
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  • For correspondence: Jeannie.Haggerty@mcgill.ca
Danièle Roberge
2Département de Sciences de la santé communautaire, Université de Sherbrooke, Canada
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George K. Freeman
3Department of Primary Care & Social Medicine, Imperial College London, United Kingdom
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Christine Beaulieu
4St. Mary’s Hospital Research Centre, Montreal, Canada
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Abstract

PURPOSE Continuity of care among different clinicians refers to consistent and coherent care management and good measures are needed. We conducted a metasummary of qualitative studies of patients’ experience with care to identify measurable elements that recur over a variety of contexts and health conditions as the basis for a generic measure of management continuity.

METHODS From an initial list of 514 potential studies (1997–2007), 33 met our criteria of using qualitative methods and exploring patients’ experiences of health care from various clinicians over time. They were coded independently. Consensus meetings minimized conceptual overlap between codes.

RESULTS For patients, continuity of care is experienced as security and confidence rather than seamlessness. Coordination and information transfer between professionals are assumed until proven otherwise. Care plans help clinician coordination but are rarely discerned as such by patients. Knowing what to expect and having contingency plans provides security. Information transfer includes information given to the patient, especially to support an active role in giving and receiving information, monitoring, and self-management. Having a single trusted clinician who helps navigate the system and sees the patient as a partner undergirds the experience of continuity between clinicians.

CONCLUSION Some dimensions of continuity, such as coordination and communication among clinicians, are perceived and best assessed indirectly by patients through failures and gaps (discontinuity). Patients experience continuity directly through receiving information, having confidence and security on the care pathway, and having a relationship with a trusted clinician who anchors continuity.

  • continuity of patient care
  • primary health care
  • patient-centered care
  • quality of health care
  • patient satisfaction
  • process assessment (health care)
  • qualitative research
  • Received for publication April 10, 2012.
  • Revision received August 23, 2012.
  • Accepted for publication September 4, 2012.
  • © 2013 Annals of Family Medicine, Inc.
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The Annals of Family Medicine: 11 (3)
The Annals of Family Medicine
Vol. 11, Issue 3
May/June 2013
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Experienced Continuity of Care When Patients See Multiple Clinicians: A Qualitative Metasummary
Jeannie L. Haggerty, Danièle Roberge, George K. Freeman, Christine Beaulieu
The Annals of Family Medicine May 2013, 11 (3) 262-271; DOI: 10.1370/afm.1499

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Experienced Continuity of Care When Patients See Multiple Clinicians: A Qualitative Metasummary
Jeannie L. Haggerty, Danièle Roberge, George K. Freeman, Christine Beaulieu
The Annals of Family Medicine May 2013, 11 (3) 262-271; DOI: 10.1370/afm.1499
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Subjects

  • Methods:
    • Qualitative methods
  • Other research types:
    • Health services
  • Core values of primary care:
    • Continuity
    • Comprehensiveness
    • Coordination / integration of care

Keywords

  • continuity of patient care
  • primary health care
  • patient-centered care
  • quality of health care
  • patient satisfaction
  • process assessment (health care)
  • qualitative research

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