Continuity of care and patient-reported experiences in Norwegian general practice: are they linked, and does the measurement of continuity matter?

Abstract

Continuity of care has been associated with improved health and healthcare outcomes. Continuity can be measured using registry-based and patient-reported measures, but how these measures relate to patient-reported experiences is less well understood. The main aim was to assess the association between continuity of care and patient-reported experiences in Norwegian general practice, using registry-based and self-reported measures. A secondary aim was to compare the two continuity measures and examine their agreement. A cross-sectional study was conducted combining data from a national survey of patient-reported experiences with individual-level registry data on general practitioner (GP) consultations. Continuity of care was measured using a self-reported indicator of normally seeing one's own GP and a registry-based Usual Provider of Care (UPC) index. Associations with patient-reported experience scale scores were analysed using adjusted linear regression. Agreement between registry-based and self-reported continuity were examined by comparing their distributions and associations within the same study sample. Both registry-based and self-reported continuity were positively associated with higher patient-reported experience scores across all scales (P < 0.001), with stronger associations for self-reported continuity. Associations were stronger among patients with long-term conditions. Agreement between registry-based and self-reported continuity was moderate and asymmetrical: most patients with high registry-based continuity reported seeing their own GP, whereas patients with low registry-based continuity were almost equally likely to report seeing their own GP or other GPs. The findings underline the importance of continuity of care in general practice. Registry-based and self-reported continuity measures capture related but non-interchangeable aspects of continuity and provide complementary information.