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According to new research funded by the School for Primary Care Research, older patients who do not see the same GP over a period of time are at higher risk of emergency hospital admission than those who see the same or a small number of GPs.

Our study shows that lack of continuity of care in this high-risk age group is associated with more frequent emergency admissions, which in turn suggests that better continuity of care might lead to a reduction in admissions. Discontinuity of care reduces the opportunity for building trust and mutual responsibility between doctors and patients, which might underlie the increased risk of emergency hospital admission.
- Dr Peter Tammes, lead author and Senior Research Associate, CAPC, University of Bristol

Researchers at the Universities of Bristol and Oxford found that the risk of emergency hospital admission was more than twice as high for patients with the least continuity of care compared with those with high continuity of care.

The study, published in Annals of Family Medicine today, involved analysing data from 10,000 electronic records of patients aged 65 years and older, from 297 general practices in England, between April 2010 and March 2014. These data were linked to hospital records to measure the association between continuity of care and risk of emergency hospital admission. The team focused on older patients as they are seen more frequently in general practice than younger adult patients and are most at risk of emergency hospital admission.

Acute hospital services in England are under sustained pressure with increasing emergency attendances, resulting in longer waiting times in emergency departments and high bed occupancy rates. These are both associated with poorer clinical outcomes as well as greater demands on staff. Previous evidence suggests that some patients admitted as emergencies could be managed at home. Initiatives to enhance continuity of care, the researchers suggest, could potentially reduce hospital admissions. Read the CAPC press release.


Continuity of Primary Care and Emergency Hospital Admissions Among Older Patients in England  Peter Tammes et al. Annals of Family Medicine. 13 November 2017. 

Earlier publication: Why do patients seek primary medical care in emergency departments? An ethnographic exploration of access to general practice

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