Evidence map›Paper›PMID 32784220›Full record

SynthesisThe British journal of general practice : the journal of the Royal College of General Practitioners2020

Primary medical care continuity and patient mortality: a systematic review.

Richard Baker, George K Freeman, Jeannie L Haggerty, M John Bankart, Keith H Nockels

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The British journal of general practice : the journal of the Royal College of General Practitioners, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 202 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
202citing papers in PubMed, 13 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

202 citing papers in PubMed, 13 syntheses or guidelines pooled it.

  1. Pooled it
  2. Personal GP continuity improves healthcare outcomes in primary care populations: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025
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  8. Primary care micro-teams: an international systematic review of patient and healthcare professional perspectives.The British journal of general practice : the journal of the Royal College of General Practitioners · 2023
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  13. 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 · 2020
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142 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Richard BakerDepartment of Health Sciences, University of Leicester, Leicester, UK.
George K FreemanDepartment of Primary Care and Public Health, Imperial College London, London, UK.
Jeannie L HaggertyDepartment of Family Medicine, McGill University, Montreal, Canada.
M John BankartDepartment of Health Sciences, University of Leicester, Leicester, UK.
Keith H NockelsUniversity Library, University of Leicester, Leicester, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA 2018 review into continuity of care with doctors in primary and secondary care concluded that mortality rates are lower with higher continuity of care.

aimThis association was studied further to elucidate its strength and how causative mechanisms may work, specifically in the field of primary medical care. DESIGN AND

settingSystematic review of studies published in English or French from database and source inception to July 2019.

methodOriginal empirical quantitative studies of any design were included, from MEDLINE, Embase, PsycINFO, OpenGrey, and the library catalogue of the New York Academy of Medicine for unpublished studies. Selected studies included patients who were seen wholly or mostly in primary care settings, and quantifiable measures of continuity and mortality.

resultsThirteen quantitative studies were identified that included either cross-sectional or retrospective cohorts with variable periods of follow-up. Twelve of these measured the effect on all-cause mortality; a statistically significant protective effect of greater care continuity was found in nine, absent in two, and in one effects ranged from increased to decreased mortality depending on the continuity measure. The remaining study found a protective association for coronary heart disease mortality. Improved clinical responsibility, physician knowledge, and patient trust were suggested as causative mechanisms, although these were not investigated.

conclusionThis review adds reduced mortality to the demonstrated benefits of there being better continuity in primary care for patients. Some patients may benefit more than others. Further studies should seek to elucidate mechanisms and those patients who are likely to benefit most. Despite mounting evidence of its broad benefit to patients, relationship continuity in primary care is in decline - decisive action is required from policymakers and practitioners to counter this.

Indexed as

Continuity of Patient CarePrimary Health CareCross-Sectional StudiesHumansRetrospective StudiesSecondary Health Carecontinuity of patient caremortalityprimary health caresystematic review

Identifiers

PMID32784220
PMCPMC7425204

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.