- Design
- Cross-sectional baseline survey with linear regression
- Population
- 837 adults aged 65 or over in three Berlin neighbourhoods
- Primary outcome
- Association of continuity with a GP and self-rated health
- Effect
- b=0.008 (95% CI 0.002 to 0.015) per unit of continuity duration
This cross-sectional study used baseline data from the Ageing Well study in three Berlin neighbourhoods. A total of 837 adults aged 65 or over completed face-to-face interviews. Continuity was measured as duration of care at a practice and duration with the same general practitioner. Self-rated health used a single five-point item.
Most participants (84.7%) used a GP as usual source of care and 41.6% rated their health as good. Longer continuity with a GP was positively associated with self-rated health, but the effect was small (b=0.008, 95% CI 0.002 to 0.015). Lifetime morbidity explained the largest share of variation, with depressive symptoms linked to poorer and higher subjective social status to better self-rated health.
The authors suggest self-rated health may not capture what continuity delivers for older adults. A cross-sectional design cannot say which comes first: healthier people may simply stay with a GP longer.
- Continuity matters, but self-rated health is a blunt way of measuring its effect.
- Morbidity, depression and social status explained more of self-rated health than continuity did.
- Ask about low mood in older patients; depressive symptoms were linked to poorer self-rated health.
- Continuity still supports trust and coordination; this study does not argue against it.
Why it matters
It questions whether common patient-reported outcome measures capture what continuity does.
Don't overread it
A single-city cross-sectional study cannot show that continuity improves health, or that it does not.
The statistics, in plain English
A coefficient of 0.008 on a five-point scale is tiny; even though the interval excludes zero, it is not a difference a patient would notice. In a cross-sectional study, such an association can arise in either direction.
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