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 see the same family doctor for most of their visits increasing over time?
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 doctor continuity
Continuity of care is a pillar of the Patient’s Medical Home. Family doctor continuity refers to how consistently a patient visits the same family doctor. Doctor continuity can improve health outcomes for patients. Patients who see one family doctor for most of their visits tend to have better outcomes for chronic conditions that are managed mainly in primary care. They also tend to have fewer visits to the emergency department, fewer hospitalizations, decreased length of stay in hospital, and lower mortality.
- ‘High continuity’: Continuity is ‘high’ when a patient sees the same doctor for 80 per cent or more of their family doctor visits. Achieving 100 per cent continuity is difficult for a few reasons. Patients or doctors may move. Patients may need to seek treatment from another family doctor for certain conditions or when their regular family doctor is not available.
- ‘Low continuity’: Continuity is ‘low’ when less than 50 per cent of a patient’s family doctor visits are to one doctor. These patients typically visit many family doctors, often in different locations.
Considerations when viewing the results
- A goal of our primary care system is to increase the consistency of patient visits to the same family doctor.
- Some patients are cared for by a team of family doctors who work out of one clinic and will see whichever family doctor is available at the time. These patients may have ‘low continuity’ to one family doctor, but will have ‘high continuity’ to the clinic. These patients can experience the same benefits (trust, satisfaction, improved outcomes) as patients with ‘high continuity’ to one family doctor.
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