Types of continuity of care and tools for measurement
| TYPE OF CONTINUITY OF CARE | DESCRIPTION | INFORMATION ACQUIRED OR CONNECTION ESTABLISHED THROUGH ... | EXAMPLES OF MEASUREMENT TOOLS |
|---|---|---|---|
| Interpersonal or relational | Enduring emotional connection of the physician to the patient | Caring for a patient over time, in situations that allow a unique body of knowledge about that patient to build and an emotional link to the patient to be established | Patient satisfaction surveys capture the connection of patient to physician2–5; no tool exists to capture the connection of physician to patient |
| Longitudinal | Care provided to a patient over time | Build-up of knowledge over time; seeing how the patient changes and the effects of care over time; familiarity | Duration of patient-provider affiliation (no. of visits from initial to final encounter); intensity of patient-provider affiliation (no. of visits in a defined interval); COC (no. of providers per patient); UPC (no. of visits in a given period compared with total no. of visits); COC Index (measures no. of different providers seen); K Index (known provider continuity; measures COC with different providers)2–4,6 |
| Geographic | Care provided to a patient in different settings (eg, office, hospital, home) | Seeing the environment patients establish for themselves; attending to and discussing personal mementos (eg, pictures, photographs) | No tool |
| Interdisciplinary | Care provided across disciplines (ie, 1 doctor providing different types of care) or coordination of care by 1 caregiver (ie, overseeing care of different specialists for the patient) | Putting together disparate pieces of information from many sources | Evidence of indicated follow-up for particular problems6 |
| Informational | Availability of patient’s past information | Connection builds as knowledge about the patient becomes more personalized | Evidence of information transfer (compare patient surveys with medical record)6 |
| Family | Care provided by 1 caregiver to different members of a family | Learning about patients in the unique context only family members can describe; understanding patients further through seeing how they assume different roles in the family | Proportion of immediate family members cared for by 1 provider; family Continuity of Care Index2 |
COC—concentration of care, UPC—usual provider of care.