The following is a summary of “Patient Reported Measures of Continuity of Care and Health Outcomes: A Systematic Review,” published in the August 2024 issue of Primary Care by Burch et al.
A substantial body of research has established a strong association between continuity of care and improved health outcomes. However, most studies rely on administrative measures to assess continuity, focusing primarily on the patterns of interactions between patients and clinicians. These measures often overlook the patient’s personal experience of continuity, which can be captured through patient-reported experience measures (PREMs). Unlike administrative metrics, PREMs allow for the assessment of continuity elements such as the availability of information and the coordination of care across different providers.
Patient-experienced continuity is increasingly recognized as an independent marker of healthcare quality. Despite its importance, it remains unclear whether patient-reported continuity, similar to administrative measures, is linked to positive health outcomes.
This study aimed to explore the relationship between patient-reported continuity of care and various health outcomes by analyzing cohort and interventional studies. A comprehensive search of databases including Medline, EMBASE, CINAHL, and the Cochrane Library was conducted in April 2021, supplemented by citation tracking of established continuity measures. Studies were evaluated for quality using the QUIP and Cochrane risk of bias tools, and a box-score method was employed for synthesizing the findings.
Nineteen studies met the inclusion criteria. Of these, 15 utilized validated, multifactorial questionnaires or the continuity/coordination subscale of another instrument to measure continuity. Two studies categorized patients into discrete continuity groups based on predefined questions, one used a custom-designed questionnaire, and one calculated an administrative measure of continuity using patient-reported data. The health outcomes assessed across these studies included quality of life (n = 11), self-reported health status (n = 8), emergency department utilization or hospitalization (n = 7), functional or wellbeing indicators (n = 6), mortality (n = 4), and physiological measures (n = 2). The analysis was constrained by the small number and heterogeneity of the studies, yet most demonstrated a link between at least one measure of continuity and a health outcome.
The findings suggest an emerging connection between patient-reported continuity and various health outcomes, though the evidence is not as robust as that for administrative measures of continuity. This disparity may stem from the inherent differences between what administrative and patient-reported measures capture or the smaller sample sizes in studies using patient-reported measures, which may limit their ability to detect more subtle effects. Future research should focus on larger sample sizes to determine if a definitive link exists and to elucidate the potential mechanisms driving this association. Researchers and healthcare administrators should carefully select the most appropriate continuity measure based on the context and objectives of their studies.
Source: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-024-02545-8
The post Evaluating the Link Between Patient-Reported Continuity of Care and Health Outcomes first appeared on Physician's Weekly.