- Design
- Retrospective population-based cross-sectional study, 3 years
- Population
- About 70,000 matched patients with chronic disease, Alberta, Canada
- Primary outcome
- Health service costs by clinic continuity level
- Effect
- High continuity associated with lower acute care costs; modelled savings up to £898 million
This retrospective analysis in Alberta compared about 70,000 matched patients with chronic disease, drawn from a cohort of 500,000, attending primary care clinics with low, moderate or high continuity over three years. Continuity was measured as the share of visits made to the patient's usual clinic. Published in the British Journal of General Practice on 1 October 2026.
Higher clinic continuity was associated with lower acute care costs. The authors estimate that moving all patients in lower-continuity clinics to high continuity could save up to £898 million over three years, with the largest per-patient gains in the most complex patients.
The finding extends the evidence on continuity from the individual doctor to the clinic team, which matters as practices move to shared and team-based models.
The savings are modelled from associations, not observed after a change, and patients who attend one clinic consistently may differ in other ways.
- Encourage patients with chronic disease to stay with one clinic and team
- Book follow-up with the same clinician or team where possible
- Prioritise continuity for the most complex patients, where the benefit appears largest
- Keep shared records complete so continuity survives when the usual doctor is away
Why it matters
Continuity at the level of the clinic, not only the individual doctor, appears to carry value.
Don't overread it
The savings figure is a model built on associations; it does not show that changing continuity would save that much.
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