Evidence map›Paper›PMID 40032595›Full record

Observational studyBMJ open quality2025

Continuity of care in a pandemic: an observational study in GP-centred healthcare in Germany.

Gunter Laux, Michel Wensing, Attila Altiner, Ruediger Leutgeb

Abstract readObservational Study
In one paragraph

Observational study in BMJ open quality, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–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

4 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
  4. Article
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

4 authors.

Gunter Laux *Department of General Practice and Health Services Research, Heidelberg University, Heidelberg, Germany gunter.laux@med.uni-heidelberg.de.ORCID http://orcid.org/0000-0002-8032-5459
Michel Wensing *Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany.
Attila AltinerDepartment of General Practice and Health Services Research, Heidelberg University, Heidelberg, Germany.
Ruediger LeutgebDepartment of General Practice and Health Services Research, Heidelberg University, Heidelberg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundContinuity of care (COC) refers to the sustained quality of healthcare over time and is a central element of effective general practice. High levels of COC have been associated with improved health outcomes, including reduced risks of hospitalisation. Previous research demonstrated that participation in Germany's "general practitioner-centred healthcare" (GPCHC) programme, designed to strengthen general practice care, led to higher COC. Furthermore, higher COC was independently linked to decreased risks of hospitalisations, including rehospitalisations and avoidable admissions. This study aimed to investigate whether the benefits of COC for GPCHC patients persisted in 2020, the first year of the COVID-19 pandemic, compared with 2019, the year preceding the pandemic.

methodsAn observational study was conducted in Germany using data from a health insurance database. The study included two patient cohorts: those enrolled in the GPCHC programme (n=1 049 910) and those not enrolled in GPCHC (n=537 759) for both 2019 and 2020. The analysis compared three measures of COC-Usual Provider Index, Herfindahl Index and Sequential Continuity Index-adjusted for patient characteristics. Longitudinal multivariable regression models were employed to evaluate differences between the cohorts and assess the impact of the COVID-19 pandemic on COC outcomes.

resultsFor GPCHC patients, COC in general practice was relevantly and significantly higher with respect to the three COC measures in 2019. We could observe the same advantage for GPCHC patients in 2020. Interestingly, for the SCI index, indicating the fraction of sequential encounter pairs at which the same provider is seen, we could observe that COC was even more advantageous for GPCHC patients in 2020 in comparison to 2019. Finally, we could observe that higher COC in 2019 was independently associated with decreased healthcare utilisation of the inpatient care sector in 2020.

conclusionsIn a pandemic period in which healthcare is faced with new challenges, both for patients and healthcare providers, GPCHC was still associated with higher COC. The GPCHC programme and its contents are obviously better up to the requirements of the COC even in such a situation of pandemic-induced discontinuity.

Indexed as

Continuity of Patient CareCOVID-19General PracticeAdultAgedFemaleGermanyHumansMaleMiddle AgedPandemicsPatient-Centered CareSARS-CoV-2CommunicationContinuity of Patient CareHealth services research

Identifiers

PMID40032595
PMCPMC11877195

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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.