Two new aspects of continuity of care
OBJECTIVE: To determine whether the original continuity of care framework is still applicable to family medicine today.
DESIGN: Qualitative descriptive study.
SETTING: Kingston, Ont.
PARTICIPANTS: Three groups of first-year family medicine residents (18 in total), 2 groups of family physicians in established comprehensive practices (9 in total), and 2 groups of family physicians working in episodic care settings (10 in total).
METHODS: Using focus groups, a semistructured discussion guide, and a qualitative descriptive design, we explored the residents' and practising physicians' conceptions about continuity of care. Qualitative content analysis was used to identify themes.
MAIN FINDINGS: Focus group participants consisting of family physicians providing comprehensive care, episodic care physicians, and family medicine residents exposed 2 new dimensions of continuity of care-community continuity of care (the physicians' roles in understanding the lives of their patients, and how this affects their overall health) and continuity of care within the health care team (the continuity between a patient and members of the interprofessional team, including the family physician). Geographic continuity of care (the care of a patient in various settings by the same physician) was not prominently discussed, perhaps reflecting the paucity of family physicians in the hospital setting.
CONCLUSION: Both of these new dimensions of continuity of care are consistent with the ongoing evolution of family medicine as a discipline, and have important implications for how family medicine training programs should be designed to best prepare trainees for future practice.