• Sahar Pahlavanyali, Øystein Hetlevik, Jesper Blinkenberg, and Steinar Hunskaar.
• Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
• Fam Pract. 2022 Jul 19; 39 (4): 570-578.

BackgroundContinuity of care (CoC) is accepted as a core value of primary care and is especially appreciated by patients with chronic conditions. Nevertheless, there are few studies investigating CoC for these patients across levels of healthcare.ObjectiveThis study aims to investigate CoC for patients with somatic chronic diseases, both with regular general practitioners (RGPs) and across care levels.MethodsWe conducted a registry-based observational study by using nationwide consultation data from Norwegian general practices, out-of-hours services, hospital outpatient care, and private specialists with public contracts. Patients with diabetes mellitus (type I or II), asthma, chronic obstructive pulmonary disease, or heart failure in 2012, who had ≥2 consultations with these diagnoses during 2014 were included. CoC was measured during 2014 by using the usual provider of care (UPC) index and Bice-Boxerman continuity of care score (COCI). Both indices have a value between 0 and 1.ResultsPatients with diabetes mellitus comprised the largest study population (N = 79,165) and heart failure the smallest (N = 4,122). The highest mean UPC and COCI were measured for patients with heart failure, 0.75 and 0.77, respectively. UPC increased gradually with age for all diagnoses, while COCI showed this trend only for asthma. Both indices had higher values in urban areas.ConclusionsOur findings suggest that CoC in Norwegian healthcare system is achieved for a majority of patients with chronic diseases. Patients with heart failure had the highest continuity with their RGP. Higher CoC was associated with older age and living in urban areas.© The Author(s) 2021. Published by Oxford University Press.

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