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Hogne Sandvik, Øystein Hetlevik, Jesper Blinkenberg, Steinar Hunskaar
BACKGROUND: Continuity, usually considered a quality aspect of primary care, is under pressure in Norway, and elsewhere. AIM: To analyse the association between longitudinal continuity with a named regular general practitioner (RGP) and use of out-of-hours (OOH) services, acute hospital admission, and mortality. DESIGN AND SETTING: Registry-based observational study in Norway covering 4 552 978 Norwegians listed with their RGPs. METHOD: Duration of RGP-patient relationship was used as explanatory variable for the use of OOH services, acute hospital admission, and mortality in 2018. Several patient-related and RGP-related covariates were included in the analyses by individual linking to high-quality national registries. Duration of RGP-patient relationship was categorised as 1, 2-3, 4-5, 6-10, 11-15, or >15 years. Results are given as adjusted odds ratio (OR) with 95% confidence intervals (CI) resulting from multilevel logistic regression analyses. RESULTS: Compared with a 1-year RGP-patient relationship, the OR for use of OOH services decreased gradually from 0.87 (95% CI = 0.86 to 0.88) after 2-3 years' duration to 0.70 (95% CI = 0.69 to 0.71) after >15 years. OR for acute hospital admission decreased gradually from 0.88 (95% CI = 0.86 to 0.90) after 2-3 years' duration to 0.72 (95% CI = 0.70 to 0.73) after >15 years. OR for dying decreased gradually from 0.92 (95% CI = 0.86 to 0.98) after 2-3 years' duration, to 0.75 (95% CI = 0.70 to 0.80) after an RGP-patient relationship of >15 years. CONCLUSION: Length of RGP-patient relationship is significantly associated with lower use of OOH services, fewer acute hospital admissions, and lower mortality. The presence of a dose-response relationship between continuity and these outcomes indicates that the associations are causal.
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Sandvik, H., Hetlevik, Ø., Blinkenberg, J., & Hunskaar, S. (2021). Continuity in general practice as predictor of mortality, acute hospitalisation, and use of out-of-hours care: a registry-based observational study in Norway. British Journal of General Practice, 72(715), e84–e90. https://doi.org/10.3399/bjgp.2021.0340
Sandvik, Hogne, et al. "Continuity in general practice as predictor of mortality, acute hospitalisation, and use of out-of-hours care: a registry-based observational study in Norway." British Journal of General Practice, vol. 72, no. 715, 2021, pp. e84–e90, https://doi.org/10.3399/bjgp.2021.0340.
Sandvik, Hogne, Øystein Hetlevik, Jesper Blinkenberg, and Steinar Hunskaar. "Continuity in general practice as predictor of mortality, acute hospitalisation, and use of out-of-hours care: a registry-based observational study in Norway." British Journal of General Practice 72, no. 715 (2021): e84–e90. https://doi.org/10.3399/bjgp.2021.0340.
Sandvik H., Hetlevik Ø., Blinkenberg J. [и др.] Continuity in general practice as predictor of mortality, acute hospitalisation, and use of out-of-hours care: a registry-based observational study in Norway // British Journal of General Practice. — 2021. — Vol. 72, № 715. — P. e84–e90. — URL: https://doi.org/10.3399/bjgp.2021.0340
@article{sandvik2021continuity,
title = {{Continuity in general practice as predictor of mortality, acute hospitalisation, and use of out-of-hours care: a registry-based observational study in Norway}},
author = {Hogne Sandvik and Øystein Hetlevik and Jesper Blinkenberg and Steinar Hunskaar},
journal = {British Journal of General Practice},
year = {2021},
volume = {72},
number = {715},
pages = {e84--e90},
doi = {10.3399/bjgp.2021.0340},
url = {https://doi.org/10.3399/bjgp.2021.0340}
}TY - JOUR AU - Sandvik, Hogne AU - Hetlevik, Øystein AU - Blinkenberg, Jesper AU - Hunskaar, Steinar TI - Continuity in general practice as predictor of mortality, acute hospitalisation, and use of out-of-hours care: a registry-based observational study in Norway JO - British Journal of General Practice VL - 72 IS - 715 SP - e84 EP - e90 PY - 2021 DA - 2021/08/26 DO - 10.3399/bjgp.2021.0340 UR - https://doi.org/10.3399/bjgp.2021.0340 ER -
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