Continuity of Care Evaluation: The View of Patients and Professionals about Urban Family Physician Program

Abstract

Background: A responsibility of the family physician (FP) and one of the four aspects of the delivery of primary care services is continuity of care (COC). This study aimed to determine the
COC of health care in urban health centers.

Methods: Between September 2015 and March 2016, we conducted a cross‑sectional study using Primary Care Evaluation Tool questionnaires with multistage stratified cluster sample
of FPs (n = 141) and patients (n = 710) in two provinces in Iran, Fars and Mazandaran. The questionnaires contained essential dimensions of COC: Informational, interpersonal, and
longitudinal COC.

Results: Almost all FPs had a computer. The FPs hadn’t kept their patients’ medical records routinely. The software had some problems, so the FPs couldn’t produce lists of patients based
on their health risk and they couldn't monitor their population. Almost 88% of FPs have written referral letters for all referred patients but 57% of them got medical feedback from specialists.
About 80% of patients’ consultation times were up to 10 min. 29% of FPs knew the past problems and illnesses of the patients. From 40% to 50% of the patients stated that their FPs asked them for their desire about prescribed medicine and gave clear explanation about their illnesses. On average, patients visited their doctor 5.5 times during the previous year. Generally, patients and FPs in Mazandaran could summarize their experiences better than Fars in most topics of COC.

Conclusions: It seems that after 3 years of using urban FP program in two pilot provinces, there were still some problems in COC. Strengthen software program, introducing incentives for FPs, and promoting patients’ responsibility can be used by policy‑makers when they seek to enhance COC.

Keywords: Continuity of care, family physician, Iran, Primary Care Evaluation Tool