Continuing care is good for patients

Continuing care is good for patients

Staying with the same GP reduces the chance of premature death, a study by Exeter Medical School, published in BMJ Open has found. This echoes a finding of the Steele Review of NHS dentistry, which said: “Continuity of care matters to patients and to dentists. It is important in building a relationship of trust and a philosophy of lifelong care.”

The GP review found that patients were more likely to complete courses of treatment, live healthily between consultations and be candid about their symptoms when treated by GPs they knew well. But the researchers said health chiefs risked being blinded by the benefits this brings because of the fast pace of technological change.

The Exeter study into death rates and continuity of care analysed the results of 22 surveys carried out in nine countries with different health systems. Of those, 18 – 82 per cent – found that repeated contact with the same doctor over time meant significantly fewer deaths over the study periods compared with those without continuity.

Sir Denis Pereira Gray, who led the study, said: “Patients have long known that it matters which doctor they see and how well they can communicate with them. Until now, arranging for patients to see the doctor of their choice has been considered a matter of convenience or courtesy. Now it is clear it is about the quality of medical practice and is literally a matter of life and death.”

Dentistry

“Continuity of care matters to patients and to dentists. It is important in building a relationship of trust and a philosophy of lifelong care. This is at the heart of the pathway, but a continuing care relationship implies responsibilities and rights on both sides. We recommend that patients registered in a continuing care relationship with a practice have an absolute right to return to that practice for both routine and urgent care”. From NHS dental services in England, An independent review led by Professor Jimmy Steele, June 2009.

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Mike Wanless
Continuing care is good for patients
There is other evidence that continuity of care is important in patient satisfaction with dentists and dental care. In 1982 Davis and Ware conducted a major study in USA which showed a strong positive correlation between continuity of care and patient satisfaction. They also showed that patients judge their dentist on their interpersonal skills (showing that they care) rather than their perceived technical skills (their ability to cure).

There is a reasonable possibility that those who live longer are more grateful to their doctor too, so that they may live longer and be happier, but often at the top end it is quality rather than quantity that is the important issue.

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