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Abstract

Background: Relational continuity, ‘a therapeutic relationship between a patient and provider/s that spans health care events’, has been associated with improved patient outcomes.Objectives: To evaluate whether an intervention incorporating patient enrolment and a funding model for higher-risk patients influenced patient-reported experience measures, particularly relational continuity.Methods: Cluster-randomized controlled trial over 12 months (1 August 2018–31 July 2019). Participating patients within intervention practiceswere offered enrolment with a preferred general practitioner, a minimum of 3 longer appointments, and review within 7 days of hospital admission or emergency department attendance. Intervention practices received incentives for longer consultations (dependent on reducing unnecessary prescriptions and tests), early post-hospital follow-up, and hospitalization reductions. The primary outcome was patient-reported relationalcontinuity, measured by the Primary Care Assessment Tool Short Form.Results: A total of 774 patients, aged 18–65 years with a chronic illness or aged over 65 years, from 34 general practices in metropolitan, regional, and rural Australia across 3 states participated. Response rates for questionnaires were >90%. From a maximum of 4.0, mean baselinescores for relational continuity were 3.38 (SE 0.05) and 3.42 (SE 0.05) in control and intervention arms, respectively, with no significant between-group differences in changes pre-post trial. There were no significant changes in other patient-focussed measures.Conclusion: Patient-reported relational continuity was high at baseline and not influenced by the intervention, signalling the need for cautionwith policies incorporating patient enrolment and financial incentives. Further research is required targeting at-risk patient groups with low baseline engagement with primary care.

Item Type:	Article
Authors/Creators:	Bonney, A and Russell, G and Radford, J and Zwar, N and Mullan, J and Batterham, M and Mazza, D and Peterson, G and Eckermann, S and Metusela, C
Keywords:	chronic disease, continuity of patient care, general practice, patient-reported outcome measures, policy, prospective studies
Journal or Publication Title:	Family Practice
Publisher:	Oxford Univ Press
ISSN:	0263-2136
DOI / ID Number:	https://doi.org/10.1093/fampra/cmab157
Copyright Information:	© The Author(s) 2021. This article is licensed under a Creative Commons Attribution 4.0 International License, (https://creativecommons.org/licenses/by/4.0/) which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made
Related URLs:	Google Scholar: Radford, J UTAS Profile: Radford, J UTAS Profile: Peterson, G
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