Continuity of care in the context of a primary health care reform: a follow-up after the Swedish <italic>Patient Choice Reform</italic>.

AbstractBackgroundMethodsResultsConclusionsContinuity of care (CoC) is essential for effective primary health care (PHC), yet Swedish PHC has historically exhibited low levels of continuity. The Swedish <italic>Patient Choice Reform</italic> introduced privatization and market-oriented principles in...

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Publicado en:Scandinavian Journal of Primary Health Care pp. 1 - 14
Autores principales: Kohnke, Hannes, Zielinski, Andrzej, Beckman, Anders, Ohlsson, Henrik
Formato: Journal Article
Publicado: Taylor & Francis Ltd Jul2025
Acceso en línea:Ver este registro en EBSCOhost
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      jtl: Scandinavian Journal of Primary Health Care
      issn: 02813432
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      dt: Jul2025
      pid: 377
      pub: Taylor & Francis Ltd
      place: Philadelphia, Pennsylvania
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        186448097
        10.1080/02813432.2025.2527856
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        atl: Continuity of care in the context of a primary health care reform: a follow-up after the Swedish <italic>Patient Choice Reform</italic>.
      aug:
        au:
          Kohnke, Hannes
          Zielinski, Andrzej
          Beckman, Anders
          Ohlsson, Henrik
        affil: Department of Clinical Sciences, Faculty of Medicine, Lund University
      sug:
      ab: AbstractBackgroundMethodsResultsConclusionsContinuity of care (CoC) is essential for effective primary health care (PHC), yet Swedish PHC has historically exhibited low levels of continuity. The Swedish <italic>Patient Choice Reform</italic> introduced privatization and market-oriented principles into PHC, leading to increased utilization and growing inequities in service use driven by socioeconomic disparities and misalignment with health care needs. However, little is known about its impact on continuity. The aim of this study is to explore long-term effects of longitudinal CoC in PHC within the context of the <italic>Patient Choice Reform</italic>.Using register data from Region Skåne (2007–2017), we created three closed cohorts, each capturing three years of PHC utilization. Continuity with GPs was measured using the Continuity of Care Index (CoCI). Quantile regression assessed associations between continuity and individual characteristics, including age, sex, income, education and residence.Among 322,641 individuals with 7,878,642 general practitioner (GP) visits, median CoCI declined from 0.17 (2007 cohort) to 0.13 (2015 cohort). Higher age, male sex and increased PHC utilization were linked to greater continuity in 2007, but these associations weakened by 2015.Continuity of care in Swedish PHC declined over time, particularly among older individuals and frequent PHC users. These findings highlight the need to address continuity deterioration in the context of the <italic>Patient Choice Reform</italic>.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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