Continuity of care: a multidisciplinary review

Continuity of care: a multidisciplinary review

22 NOVEMBER 2003 | Jeannie L Haggerty, Robert J Reid, George K Freeman, Barbara H Starfield, Carol E Adair, Rachael McKendry
The concept of continuity of care spans multiple disciplines and organizations. This review aims to develop a common understanding of continuity to enable accurate and reliable measurement of care in various settings. Patients often receive care from various providers across different organizations, leading to concerns about fragmented care. While policy reports and charters globally emphasize the need for improved continuity, definitions remain inconsistent, and terms like continuum of care, coordination, and seamless care are often used interchangeably. The review analyzed 2439 documents, identifying five common themes, with two core elements distinguishing continuity: care of an individual patient and care delivered over time. These elements must both be present for continuity to exist. Three types of continuity were identified: informational, management, and relational. Informational continuity involves using past information to guide current care. Management continuity focuses on consistent care for chronic conditions. Relational continuity involves ongoing relationships between patients and providers. Continuity is experienced as coherent and connected care that aligns with a patient's needs and context. It is not just about the quality of care but also about the consistency and coordination over time. Continuity is essential in primary care, mental health, nursing, and disease management. It ensures that care is delivered in a coherent and timely manner, with a focus on the individual patient. The review highlights the importance of understanding the mechanisms through which continuity improves outcomes. Processes like care pathways and case management do not equate to continuity. Continuity is experienced differently by patients and providers, posing challenges for evaluation. The review aims to clarify the concept of continuity, helping providers avoid confusion and use universally recognized terms. Regardless of the context, all types of continuity can contribute to better quality of care.The concept of continuity of care spans multiple disciplines and organizations. This review aims to develop a common understanding of continuity to enable accurate and reliable measurement of care in various settings. Patients often receive care from various providers across different organizations, leading to concerns about fragmented care. While policy reports and charters globally emphasize the need for improved continuity, definitions remain inconsistent, and terms like continuum of care, coordination, and seamless care are often used interchangeably. The review analyzed 2439 documents, identifying five common themes, with two core elements distinguishing continuity: care of an individual patient and care delivered over time. These elements must both be present for continuity to exist. Three types of continuity were identified: informational, management, and relational. Informational continuity involves using past information to guide current care. Management continuity focuses on consistent care for chronic conditions. Relational continuity involves ongoing relationships between patients and providers. Continuity is experienced as coherent and connected care that aligns with a patient's needs and context. It is not just about the quality of care but also about the consistency and coordination over time. Continuity is essential in primary care, mental health, nursing, and disease management. It ensures that care is delivered in a coherent and timely manner, with a focus on the individual patient. The review highlights the importance of understanding the mechanisms through which continuity improves outcomes. Processes like care pathways and case management do not equate to continuity. Continuity is experienced differently by patients and providers, posing challenges for evaluation. The review aims to clarify the concept of continuity, helping providers avoid confusion and use universally recognized terms. Regardless of the context, all types of continuity can contribute to better quality of care.
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