Azam, Iqbal

Khan, M

Qidwai, Waris

Rehman, J

English

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eCommons@AKUDepartment of Family Medicine Medical College, PakistanJanuary 2005Continuity of patient care among family practicepatients at a teaching hospitalWaris QidwaiAga Khan University, waris.qidwai@aku.eduJ RehmanM KhanIqbal AzamAga Khan University, iqbal.azam@aku.eduFollow this and additional works at: https://ecommons.aku.edu/pakistan_fhs_mc_fam_medPart of the Family Medicine CommonsRecommended CitationQidwai, W., Rehman, J., Khan, M., Azam, I. (2005). Continuity of patient care among family practice patients at a teaching hospital.Journal of College of Physicians and Surgeons Pakistan, 15(10), 646-647.Available at: https://ecommons.aku.edu/pakistan_fhs_mc_fam_med/131SHORT COMMUNICATION CONTINUITY OF PATIENT CARE AMONG FAMILY PRACTICE PATIENTS AT A TEACHING HOSPITAL . Waris Qidwai, Javeria Rehman,* Maria Khan* and Syed Iqbal Azam "Continuity of patient care" is considered an essential component of primary care including family practice.J,2 It is provided on a continuing basis, starting from the initial contact and includes following the patient through all phases of medical care. It has been observed that continuity of patient care improves quality of patient care, results in better health outcomes3 and increases level of patient satisfaction.4.5 Continuity of patient care improves adherence to treatment, overall service utilization, and cost of medical care. A cross-sectional analytical study was conducted at the Family Practice Center of Aga Khan University Hospitat Karachi_ Pakistan, in June 2004. On an average, 150 family practice patientg with primary care level problems were seen daily by 12 family physicians. A questionnaire was developed by the principal investigator after extensive literature search including input from colleagues and patients. It was administered in English and Urdu, depending on patient's comfort and ability. A pilot study was conducted before the start of the administration of final questionnaire. The questionnaire was administered in the waiting area outside the physician's office, prior to the consultation. Ethical requirement including the administration of written informed consent and the provision of confidentiality were ensured. Patients were interviewed based on their availability and convenience. SPSS computer software was used for data management. One hundred patients were interviewed. The mean age of the study population was 37.94 years, majority of the subjects being females with 48% respondents having graduate or more education. Only 30% and 32% respondents were willing to consult a family physician in frequency and period respectively, as per physician's advice. Thirtynine percent respondents were willing for four weeks follow-up care only, while 45% were not willing to follow-up with physician after resolution of medical problem. Seventy percent respondents reported chances of changing their physicians JS unlikely during treatment_ however, 58% were found to have sometime changed their physicians. Ninetyfive percent respondents desired to seek treatment from one physician while 97% considered continuity of patient care as necessary. The other findings of this study are given in Table I. Department of Family Medicine, The Aga Khan University, Stadium Road. Karachi-74800, Pakistan. *Department gf .. ~a_rn!!Y .. ~~~!~!.n_~\.!?.9:-." University of Health Sciences, Karachi Correspondence: Dr_ Waris Oidwai, Associate Professor, Family Medicine, The Aga Khan University, Stadium Road, P.O. Box: 3500, Karachi-74800, Pakistan E-mail: waris~_<?-k~l)_e_t:C?~ ... Received February 08, 2005; accepted July 12, 2005 646 Table 1: Patients responses to questions about continuity of care Patient responses Do you seek treatment till the resolution of your medical complaint? "' No Number Patient responses (percent) Has your family physician talked to you about contmuity of medical care? 93(g3) Yes 07(07) No . Advantages of continuing medrcal treatment till the end? {responseS=130) Disadvantages of continuing medical treatment till the end? (responses=42) Resolution of disease 31 {24) Prevention of complications 30(30) Maintain good health 29{22) Good quality life 25{19) Awareness about health 09(07) Not cost effective Da~ y routine is hampered Stressful Side effects from treatment Maintenance of heath record 06(05) - ~- ~~~--~-~~--~-~=-:-=c-c-c-··c c-;--c-----. Do you have a regular Have you suffered due to lack family physician? of continuity of medical care? - 61.1) - ~ No 39{3g) No 78(78) Consequence of lack ot Will you maintain continuity continuity of medical care: of medical care in future? {responses=22} AggravatiOn of symptoms Complrcations Late diagnosis Do you decide on return visit with your physician? y, No Does your physrcian tell you what to do if you need help prior to next apporntment? y, NO 16(73) 04(18) 02(09) 93{93) 07(07) n(77J 23(23) Ye' No Don't know Do you keep your appointment with your physician? Always Often Sometimes Never Ways a physician can help improve continuity of medical care (responses=97) Good attitude towards patient Proper diagnosis and treatment Try to satisfy patient Educate patient Be available 94(94) OO(OS: 65(65) 20(20) 13(13) 02(02) 38(39) 24(25) 20(21) 10(10) 05(05) Since the sample size was limited and the respondents were mostly educated women, the results of this study cannot be generalized to the rest of the population. Despite such a limitation, it is a valuable data on the critical issue oj continuity of patient care, which can have very important implications for medical practice. It is important to note that the willingness to consult family physician, even after the resolutions of the medical complaint, is present among half the respondents. It stresses the need to educate patients to reason why continuity of care is considered essentiaL Unless the patients are themselves convinced ofthe benefits of continuity of medical care, it is unlikely to materialize in practice. A very high proportion of patients indicated chances ol continuing treatment from the same family physician, unles~ there was no relief in their symptoms. It is most encouraging to note that almost all the respondents considered continui~· of patient care as necessary. It then becomes essential for us to investigate the reasons as to why patients were unable to maintain the continuity of care they desired. It must be noted with concern that almost two-third family physicians did not talk about continuity of patient care with their patients. In the light of this finding, it is indeed commendable that an overwhelming majority still considers continuity of patient care as necessary. JCPSP 2005, VoL 15 (10): 646~647 Continuity of patient care among family practice patients Further studies and intervention strategies are recorrunended regarding patient's education and physician's responsibilities for the improvement of continuity of patient care. REFERLI\CI·S 1. · O'Malley AS. Current evidence on the impact of continuity of care. Curr Opin Pediatr 2004; 16: 693-9. 2. McWhinney IR. An introduction to family medicine. New York: Oxford Unii,ersity Press; 1981. 3. Cabana MD, Jee SH. Does continuity of care improve patient outcomes? j Fam Pract 2004; 53: 974-80. 4. Saultz JW, Albedaiwi W. Interpersonal continuity of care and patient satisfaction: a critical review.AnnFamMed 2004; 2:445-51. 5. Weyrauch KF. Does continuity of care increase HMO patients' satisfaction with physicians' performance? JAm Board Fam Pract 1996; 9: 31~, , , , -#c , , JCPSP 2005, Vol. 15 (10): 646-647 

Continuity of patient care among family practice patients at a teaching hospital

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Continuity of patient care among family practice patients at a teaching hospital

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