A named GP increases self-reported access to health care services

Abstract

Background Continuity of care strengthens health promotion and decreases mortality, although the mechanisms of these effects are still unclear. In recent decades, continuity of care and accessibility of health care services have both decreased in Finland. Objectives The aim of the study was to investigate whether a named and assigned GP representing continuity of care is associated with the use of primary and hospital health care services and to create knowledge on the state of continuity of care in a changing health care system in Finland. Methods The data are part of the Health and Social Support (HeSSup) mail survey based on a random Finnish working age population sample of 64,797 individuals drawn in 1998 and follow-up surveys in 2003 and 2012. The response rate in 1998 was 40% (n = 25,898). Continuity of care was derived from the 2003 and 2012 data sets, other variables from the 2012 survey (n = 11,924). The principal outcome variables were primary health care and hospital service use reported by participants. The association of the explanatory variables (gender, age, education, reported chronic diseases, health status, smoking, obesity, NYHA class of any functional limitation, depressive mood and continuity of care) with the outcome variables was analysed by binomial logistic regression analysis. Results A named and assigned GP was independently and significantly associated with more frequent use of primary and hospital care in the adjusted logistic regression analysis (ORs 1.53 (95% CI 1.35–1.72) and 1.19 (95% CI 1.08–1.32), p < 0.001). Conclusion A named GPs is associated with an increased use of primary care and hospital services. A named GP assures access to health care services especially to the chronically ill population. The results depict the state of continuity of care in Finland. All benefits of continuity of care are not enabled although it still assures treatment of population in the most vulnerable position.

A named General Practitioner (GP) is associated with an increase of hospital days in a single predictor analysis: a follow-up of 15 years

“…In Finland, a named and assigned GP is a concept representing continuity of care to the population. In previous studies, the concept has been shown to associate positively with satisfaction and the use of health care services ( 14 , 15 ), which supports the adequateness of the use of only a single question.…”

“…In a situation of decreased accessibility, fragmented continuity of care and lack of resources the named GP increases accessibility of health care services [ 15 ]. The contribution of the named GP to operationalize continuity of care is amplified in the present study.…”

“…Naturally, for continuity of care to implement, also accessibility to health care services should be enabled. In previous studies multiple benefits of continuity of care seem to be mediated to the population by named GPs [ 13 – 15 ].…”

Documentation of comorbidities, lifestyle factors, and asthma management during primary care scheduled asthma contacts

“…The use of ready-made phrase templates has become more common since the SAAS study period, which may have improved screening and assessment of asthma control-related issues. However, problems with accessibility to PHC have been increasing 48 , 68 , and it is very likely that asthma treatment and follow-up is largely carried out during visits for other conditions or for other reasons. A new, long-term follow-up study from the 2010s to 2020s would be needed to assess the current situation and whether asthma assessment has improved since the follow-up period in this study.…”

Enabling patient–physician continuity in Swedish primary care: the importance of a named GP. A registry-based observational study

“…Previous studies on Finnish survey data shows that patients reporting that they have a named GP are more satisfied with their care [22] and have greater access to care [23]. With self-reported data, these analyses cannot separate the role of having a named GP from the role of continuity at visits, as patients may answer the survey based on their experience of both.…”