title: What do we know about patients' perceptions of continuity of care? A meta-synthesis of qualitative studies.
abstract: OBJECTIVE
  The increasing complexity in healthcare delivery might impede the achievement of continuity of care, being defined as 'one patient experiencing care over time as coherent and linked'. This article aims to improve the knowledge on patients' perceptions of relational (RC), informational (IC) and management continuity (MC) across care levels.
  
  
  METHODS
  A descriptive, qualitative meta-synthesis was conducted based on a literature search in various electronic databases using the subject heading 'continuity of care' and linked key terms. We scanned retrieved articles for adherence to inclusion criteria: (i) relevance to research topic, (ii) original study adopting a qualitative design and (iii) investigating the patient's perspective. Content analysis was conducted by identification of themes and aggregation of findings.
  
  
  RESULTS
  The selected 25 studies most frequently investigated RC. Being attended to regularly and over time by one physician (RC) was valued by chronic ill patients, but balanced with convenient access by young patients (MC). Communication and information transfer across care settings as well as the gathering of holistic information about the patient were perceived to foster IC. Critical features for achieving MC were accessibility between care levels, individualized care and a smooth discharge process including the receipt of support. Patients further considered that their personal involvement was one facilitating element of continuity of care.
  
  
  CONCLUSIONS
  Patients identified elements that enhance or distract from continuity of care across boundaries. Variations in perceived importance seem to depend on both individual and contextual factors which should be taken into account during healthcare provision.
authors.affiliation: Health Policy and Health Services Research Group, Consortium for Healthcare and Social Services of Catalonia, Av. Tibidabo 21, 08022 Barcelona, Spain. swaibel@consorci.org
authors.forename: Sina
authors.initials: S
authors.lastname: Waibel
authors.forename: Diana
authors.initials: D
authors.lastname: Henao
authors.forename: Marta-Beatriz
authors.initials: MB
authors.lastname: Aller
authors.forename: Ingrid
authors.initials: I
authors.lastname: Vargas
authors.forename: María-Luisa
authors.initials: ML
authors.lastname: Vázquez
mesh_terms: D003142:Communication; D003266:Continuity of Patient Care / Q000458:organization & administration*; D006282:Health Personnel / Q000458:organization & administration; D006297:Health Services Accessibility / Q000458:organization & administration; D006801:Humans; D010358:Patient Participation; D010361:Patients / Q000523:psychology*; D011369:Professional-Patient Relations; D036301:Qualitative Research