Continuity of Care with Doctors-A Matter of Life and Death? A Systematic Review of Continuity of Care and Mortality

Pereira Gray D, Sidaway-Lee K, White E, Thorne A, Evans PH. BMJ Open. 2018 Jun 28;8(6):e021161. [CrossRef] [PubMed]

There have been many reported benefits to continuity of care including increased patient satisfaction, increased take-up of health promotion, greater adherence to medical advice and decreased use of hospital services. The authors examined whether there is also a relationship between continuity of doctor care and mortality. The authors search for peer-reviewed primary research articles, published in English which reported measured continuity of care received by patients from any kind of doctor, in any setting, in any country, related to measured mortality of those patients. Of the 726 articles identified in searches, 22 fulfilled the eligibility criteria. These studies came from nine countries with very different cultures and health systems. The authors found such heterogeneity of continuity and mortality measurement methods and time frames that it was not possible to combine the results of studies. However, 18 (81.8%) high-quality studies reported statistically significant reductions in mortality, with increased continuity of care. Sixteen of these were with all-cause mortality. According to the authors, this first systematic review reveals that increased continuity of care by doctors is associated with lower mortality rates.