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...
| Publicado en: | Scandinavian Journal of Primary Health Care pp. 1 - 14 |
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| Autores principales: | , , , |
| Formato: | Journal Article |
| Publicado: |
Taylor & Francis Ltd
Jul2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=186448097&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 186448097 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 02813432 BDB jtl: Scandinavian Journal of Primary Health Care issn: 02813432 maglogo: Y pubinfo: dt: Jul2025 pid: 377 pub: Taylor & Francis Ltd place: Philadelphia, Pennsylvania artinfo: ui: 186448097 10.1080/02813432.2025.2527856 186448097 ppf: 1 ppct: 13 formats: fmt: @attributes: type: P tig: 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 refInfo: holdings: @attributes: islocal: N |
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