Continuity of care for older patients in family practice: how important is it?

OBJECTIVE To examine the evidence that continuity of primary care is important for older people with chronic diseases.

DATA SOURCES MEDLINE, EMBASE and CINAHL were searched from January 1970 to June 2005 for original articles in English that examined the relationship between interpersonal continuity of patient care and health outcomes of people 50 years old and older. Articles found were reviewed and analyzed by both authors to assess the strength of study design and the quality of the evidence provided.

STUDY SELECTION We used the search terms "continuity of patient care," "elderly," "primary care," and "outcomes." Criteria from the Canadian Task Force on Preventive Health Care were used to assess the quality of studies; only studies providing levels I to III evidence were included in this review.

SYNTHESIS Of 7563 articles found, we chose 99 studies (and 27 other studies cited in them) by studying their abstracts. Assessment of these 126 studies indicated that only 5 were of good quality and relevant to the inquiry. Two of these 5 were randomized controlled trials, and 3 were observational studies.

CONCLUSION Although the literature on continuity of care generally suggests that continuity of interpersonal primary care is important and beneficial, specific evidence that it is beneficial for elderly people is scanty. There is a need for well designed studies to investigate this issue.