Interpersonal continuity of care: a cross-sectional survey of primary care patients'' preferences and their experiences

BACKGROUND: Developments in primary care may make the provision of interpersonal continuity more difficult. AIM: To identify those patients who regard interpersonal continuity as important and determine what makes it difficult for them to obtain this. Design of study: Cross sectional survey. SETTING: Twenty-two practices and a walk-in centre in West London and Leicestershire, UK. METHOD: Administration of a questionnaire on preferences for and experiences of interpersonal and informational continuity. Interpersonal continuity was defined in three questions: choosing a particular person; choosing someone known and trusted; and choosing someone who knows the patient and medical condition. RESULTS: One thousand four hundred and thirty-seven (46.5%) patients responded. Consulting someone known and trusted was important to 766 (62.6%) responders, although 105 (13.7%) of these reported that they had not experienced it at their last consultation. Seven hundred and eighty-eight (65.2%) responders regarded being able to consult a particular person as important, but 168 (21.3%) of these were unable to. Being in work and consulting for a new problem were associated with failing to obtain interpersonal continuity. Ethnic group was associated with failing to see someone with time to listen when this was preferred. CONCLUSION: In view of the response rate, which was particularly low among young males, some caution is required in applying the findings. Most patients experience the aspects of care important to them, although interpersonal continuity is important to many and certain groups find difficulty in obtaining it. Practices should have flexible appointment systems to account for the difficulties some patients have in negotiating for the type of care they want.