Clinic continuity linked to lower acute care costs, most for complex patients

Design

Retrospective population-level cross-sectional study

Population

About 70,000 matched patients with chronic disease in Alberta

Primary outcome

Health service utilisation costs by clinic continuity level

Effect

High continuity associated with lower acute care costs; modelled saving up to £898 million over 3 years

A retrospective cross-sectional study in Alberta, Canada, matched about 70,000 patients with chronic disease and compared health service costs over three years across clinics with low, moderate and high continuity, measured as the share of visits made to the patient's usual clinic.

High clinic continuity, 80% to 100% of visits, was associated with lower acute care costs, and the estimated per-patient savings were greatest in the most medically complex patients. The authors modelled a theoretical saving of up to £898 million over three years if all patients in lower-continuity clinics received high-continuity care.

The headline figure is a projection from an association, not a measured saving. But it adds to consistent evidence that seeing the same clinic or doctor matters most for patients with several long-term conditions, which family physicians can act on through how they book follow-up.

• Book follow-up for patients with multiple long-term conditions with the same clinician where possible.
• Flag your most complex patients so reception staff can protect continuity.
• Continuity at clinic level, not only with one doctor, was linked to lower costs.
• Use continuity as an argument when practice systems are redesigned.

Why it matters

It suggests continuity is worth protecting even in team-based practice, especially for the patients who use most care.

Don't overread it

The savings are modelled from a cross-sectional association and do not show that changing continuity reduces costs.

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