title: Fifty years of longitudinal continuity in general practice: a retrospective observational study.
abstract: BACKGROUND
  Continuity of care has been defined as relational continuity between patient and doctor and longitudinal continuity describing the duration of the relationship. Measurement of longitudinal continuity alone is associated with outcomes including patient satisfaction, medical costs, hospital admissions and mortality.
  
  
  METHODS
  In one UK general practice, records were searched for patients with continuous registration for 50 or more years. Characteristics of these patients were analysed for age, gender, social deprivation, partner registration and length of registration. Trends in numbers and proportions of this group over the previous 14 years were determined. A comparison group of patients, aged 50 or more, and registered in the same practice within the last 2-4 years, was identified.
  
  
  RESULTS
  Patients registered for 50 years or more with a median registration of 56.2 years numbered 190 out of a population of 8420 (2.3%). These patients increased in number by 35.3% (1.7-2.3%) over 14 consecutive years. There were no differences between groups for GP consultation rate, number of repeat medications and hospital use, despite the significantly higher prevalence of multi-morbidity, depression and diabetes in patients with high continuity.
  
  
  CONCLUSIONS
  This is the first report of 50-year continuity in general practice. Numbers of such patients and proportions are increasing. Longitudinal continuity is easily measured in general practice and associated with important clinical outcomes.
authors.affiliation: St Leonard's Research Practice and University of Exeter Medical School, Exeter, UK. ew312@exeter.ac.uk.
authors.forename: Eleanor S
authors.initials: ES
authors.lastname: White
authors.affiliation: St Leonard's Research Practice and University of Exeter Medical School, Exeter, UK.
authors.forename: Denis
authors.initials: D
authors.lastname: Pereira Gray
authors.affiliation: St Leonard's Research Practice and.
authors.forename: Peter
authors.initials: P
authors.lastname: Langley
authors.affiliation: St Leonard's Research Practice and University of Exeter Medical School, Exeter, UK.
authors.forename: Philip H
authors.initials: PH
authors.lastname: Evans
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003266:Continuity of Patient Care / Q000706:statistics & numerical data*; D005260:Female; D058006:General Practice / Q000639:trends*; D006760:Hospitalization; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D006113:United Kingdom
keywords: Continuity of care; doctor–patient relationship; family practice; general practice; longitudinal studies; primary care.