Emmi Lautamatti1,2, Kari Mattila3, Sakari Suominen4,5, Lauri Sillanmäki6,7, Markku Sumanen3. 1. Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland. emmi.lautamatti@tuni.fi. 2. Centre for General Practice, Pirkanmaa Hospital District, Tampere, Finland. emmi.lautamatti@tuni.fi. 3. Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland. 4. School of Health Sciences, University of Skövde, Skövde, Sweden. 5. Department of Public Health and Clinical Research Centre, University of Turku, Turku University Hospital, Turku, Finland. 6. Turku University Hospital and University of Turku, Turku, Finland. 7. Department of Public Health, University of Helsinki, Helsinki, Finland.
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.
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.
Authors: Nicholas K Schiltz; David F Warner; Jiayang Sun; Paul M Bakaki; Avi Dor; Charles W Given; Kurt C Stange; Siran M Koroukian Journal: Med Care Date: 2017-03 Impact factor: 2.983
Authors: Saul Blecker; Daniel Shine; Naeun Park; Keith Goldfeld; R Scott Braithwaite; Martha J Radford; Marc N Gourevitch Journal: Int J Qual Health Care Date: 2014-07-03 Impact factor: 2.038
Authors: Sakari Suominen; Karoliina Koskenvuo; Lauri Sillanmäki; Jussi Vahtera; Katariina Korkeila; Mika Kivimäki; Kari J Mattila; Pekka Virtanen; Markku Sumanen; Päivi Rautava; Markku Koskenvuo Journal: BMJ Open Date: 2012-03-15 Impact factor: 2.692