What do you see?
- Are there differences between zones or PCNs that are mainly urban (e.g., Calgary, Edmonton) compared to those that are mainly rural (e.g., North, Central, South)? What factors could account for this?
- Is the percentage of patients who visit the same clinic for most of their visits increasing over time?
- Are there differences between doctor continuity and clinic continuity? What could account for this?
Whether you’re a patient, provider, or health system administrator, thinking about why these differences might exist can start conversations and lead to solutions for improved quality of healthcare.
*Data courtesy of Alberta Health Services and Alberta Health
Understanding this chart
‘Clinic continuity’ is a term that refers to how consistently a patient visits the clinic where their family doctor or healthcare team works. On a visit to their clinic, a patient may see their family doctor, another doctor(s), or other healthcare professional(s) such as a nurse, pharmacist or social worker. It is becoming more common for patients to be cared for by a group of family doctors in the same clinic. The clinic that a patient visits most often to receive care becomes that patient’s ‘medical home’.
The benefits of consistently visiting the same clinic are similar to the benefits of consistently seeing the same family doctor: Greater trust between the patient and their healthcare team, increased satisfaction of patient and care team members, and improved health outcomes for patients with chronic conditions that are managed in primary care.
- ‘High’ continuity: clinic continuity is ‘high’ when a patient visits the same clinic for more than 80 per cent of their primary care visits.
- ‘Low’ continuity: clinic continuity is ‘low’ when less than 50 per cent of a patient’s clinic visits are to the same clinic. These patients visit three or more different clinics.
Considerations when viewing the results
- A goal of our primary care system is to increase the percentage of patient visits to one clinic.
- The results do not include visits to the patient’s usual clinic when a family doctor is not seen. At the present time, other healthcare providers (e.g., nurse, pharmacist) cannot bill for a patient visit in a clinic.
- The results do not include clinics (e.g., some ‘family care clinics’) without a doctor, where a team of healthcare providers (e.g., nurse practitioner, pharmacist, social worker) deliver health services to patients.
The Health Quality Council of Alberta uses the Alberta Quality Matrix for Health as a way of organizing information and thinking around the complexity of the healthcare system. The information in this chart can be used as input to think and have conversations about primary healthcare in Alberta using the lens of the dimensions of quality shown on the right:
Dimensions of Quality