title: Continuity of GP care is related to reduced specialist healthcare use: a cross-sectional survey.
abstract: BACKGROUND
  Continuity of GP care is associated with reduced hospitalisations, but solid documentation of its relationship to use of outpatient specialist services is lacking.
  
  
  OBJECTIVE
  To test the association between continuity of GP care and use of inpatient and outpatient specialist services.
  
  
  METHODS
  A cross-sectional population-based study with questionnaire data from the sixth Tromsø Study (2007-2008).
  
  
  METHODS
  Descriptive statistics and two sample t-test were used to estimate specialist healthcare use according to duration of the GP-patient relationship. Logistic regression analysis was used to assess associations between duration and intensity of the GP-patient relationship and use of specialist care. Analyses were adjusted for sex, age, marital status, income, education, and self-rated health, and also stratified by self-rated health and age.
  
  
  RESULTS
  Of 10,624 eligible GP users, 85% had seen the same GP for >2 years. The probability of visiting outpatient specialist services was significantly lower among these participants compared to those with a shorter GP relationship (odds ratio [OR] = 0.81, 95% confidence interval [95% CI] = 0.71 to 0.92). Similar findings were found for hospitalisations (OR = 0.76, 95% CI = 0.64 to 0.90). Stratified analyses revealed that these associations were not dependent on self-rated health or age. The probability of specialist use increased for the frequent GP users.
  
  
  CONCLUSIONS
  Continuity of GP care is associated with reduced use of outpatient specialist services and hospitalisations. Healthcare providers and policymakers who wish to limit use of specialist health care may do well to perform and organise health services in ways that support continuity in general practice.
authors.affiliation: National Centre for Integrated Care and Telemedicine, University Hospital of Northern Norway, Tromsø, Norway. anne.helen.hanzen@gmail.com
authors.forename: Anne Helen
authors.initials: AH
authors.lastname: Hansen
authors.forename: Peder A
authors.initials: PA
authors.lastname: Halvorsen
authors.forename: Ivar J
authors.initials: IJ
authors.lastname: Aaraas
authors.forename: Olav Helge
authors.initials: OH
authors.lastname: Førde
mesh_terms: D003266:Continuity of Patient Care / Q000592:standards / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D058006:General Practice; D006297:Health Services Accessibility; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care; D010817:Physician-Patient Relations; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology