ArticleFamily practice2015
'Falling through gaps': primary care patients' accounts of breakdowns in experienced continuity of care.
Article in Family practice, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
29 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Access or continuity: a zero sum game? A systematic review of the literature examining the relationship between access and continuity in primary healthcare.BMC primary care · 2025Pooled it
- Primary medical care continuity and patient mortality: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020Pooled it
- Using co-design to develop actionable strategies to identify and follow-up on breast cancer survivors in primary care.BMC health services research · 2026Trial
- Impact of an enhanced pharmacy discharge service on prescribing appropriateness criteria: a randomised controlled trial.International journal of clinical pharmacy · 2015Trial
- A scoping review of how the candidacy framework has been used in research on access to general practice.Journal of health services research & policy · 2026Article
- "I had to work it out for myself": opportunities for primary care to fill a void for early-onset breast cancer survivors.Journal of cancer survivorship : research and practice · 2026Article
- Experiences of Continuity of Care Among Registered Nurses Caring for Patients With Chronic Obstructive Pulmonary Disease in Primary Care: A Qualitative Study.Journal of advanced nursing · 2025Article
- Telehealth as a Substitute for a Usual Source of Care for Prescription Medications.International journal of telerehabilitation · 2025Article
- Understanding access to general practice through the lens of candidacy: a critical review of the literature.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Review
- "Shared experience makes this all possible": documenting the guiding principles of peer-led services for people released from prison.BMC public health · 2024Article
- The impact of COVID-19 on primary care accessibility and the role of telehealth for patients with chronic conditions.Health policy and technology · 2023Article
- Exploring interdependencies, vulnerabilities, gaps and bridges in care transitions of patients with complex care needs using the Functional Resonance Analysis Method.BMC health services research · 2023Article
- An intervention pilot to facilitate harm reduction service decentralization in Vietnam.Journal of substance abuse treatment · 2023Article
- In safe hands: a qualitative study on older adults' experiences of a tailored primary health care unit.Scandinavian journal of primary health care · 2022Article
- Rural general practice staff experiences of patient safety incidents and low quality of care in Norway: an interview study.Family practice · 2022Article
- [Support for General Practitioners in the Care of Patients with Complex Needs: A Questionnaire Survey of General Practitioners in Berlin].Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany)) · 2021Article
- Why does continuity of care with family doctors matter? Review and qualitative synthesis of patient and physician perspectives.Canadian family physician Medecin de famille canadien · 2021Review
- Review
- "Being in good hands": next of kin's perceptions of continuity of care in patients with heart failure.BMC geriatrics · 2019Article
- Experiences of striving to maintain daily life among women with osteoporosis.International journal of qualitative studies on health and well-being · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundExperienced continuity is important for good quality primary care but may be challenging to achieve. Little is known about how discontinuities or gaps in care may arise, how they impact on patients' experiences and how best to understand them so that they can be avoided or managed.
objectivesUsing the theoretical framework of candidacy, we aim to explore patients' experiences of discontinuities in care and to gain insight into how gaps come to be bridged and why they might remain unresolved.
methodsA secondary analysis was undertaken of interview data from a large study into continuity in primary care, involving a diverse sample of 50 patients, recruited from 15 general practices, one walk-in centre and community settings in Leicestershire, UK. Analysis was conducted using a constant comparative approach.
resultsExperiences of gaps in care were common, arising from failures in communication and coordination of care. Although some gaps were easily bridged, many patients described 'falling through gaps' because of difficulties establishing their candidacy for ongoing care when gaps occurred. These patients commonly had complex, chronic conditions and multi-morbidity. Bridging gaps required resources; relationship continuity was a valuable resource for preventing and repairing gaps in care. When gaps were not bridged, distress and dysfunctional use of health services followed.
conclusionThis study demonstrates that some patients with complex chronic conditions and multi-morbidity may be unable to get the continuity they need and highlights the potential for relationship continuity to help prevent vulnerable patients falling through gaps in care.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.