Continuity in the Provider of Home-Based Physical Therapy Services and Its Implications for Outcomes of Patients

Abstract

These findings build upon research suggesting that continuity in the patient-provider relationship is an important determinant of outcomes of patients.

Continuity of care in hospital rehabilitation services: a qualitative insight from inpatients’ experience

“… 6 , 8 However, despite increased interest, few empirical studies have been conducted into the continuity of rehabilitation care, particularly in acute-care services. In addition, most of these studies have focused on only one aspect of continuity, such as the time a patient sees the same provider over time (longitudinal continuity) 9 , 10 and have ignored the patient's point of view. Nevertheless, obtaining the perspective of patients is an important and valuable way of evaluating healthcare services.…”

High turnover in clinical dietetics: A qualitative analysis

“…Provider continuity, demonstrated in other studies to improve patient outcomes, [10][11][12][13] was noted by managers to be desirable in dietetic practice and was conspicuously lacking where churn was high. Delays in provision of nutrition therapy by a dietitian can have signi cant consequences: both nancially -for the health system and the individual patient or client, 53,54 and medically -in the form of increased morbidity and mortality associated with malnutrition.…”

“…Consistency in care provider, or provider continuity, is one component of continuity of care. 10 Inconsistent care can decrease a provider's ability to interpret changes in the patient's behavior or appearance and can weaken rapport. 10,11 Patients may become frustrated at having to repeatedly share their medical history and existing concerns.…”

“…10 Inconsistent care can decrease a provider's ability to interpret changes in the patient's behavior or appearance and can weaken rapport. 10,11 Patients may become frustrated at having to repeatedly share their medical history and existing concerns. 11 Notably, provider continuity may matter more to patients who are at the end of life, are elderly, have chronic conditions and/or who have complex histories.…”

“…More speci c to allied health professionals, results from a U.S. study on the impact of provider continuity in outpatient physiotherapy indicated that patients with lower provider continuity were less likely to experience functional improvements and were more than twice as likely to require hospitalization than those who experienced a high level of provider continuity. 10 In this study, we aimed to explore: 1) characteristics of clinical dietetic jobs in the Canadian public sector that are associated with the most churn, and 2) consequences of churn for patients and for managers of clinical dietitians. Despite the lack of literature available to guide prediction of ndings, we hypothesized that the greatest churn would be in general medicine and long-term care (gerontology) clinical dietitian positions.…”