Continuity of care among Finns 65 years or older in primary care

Background In Finland, relational continuity of care has previously been studied using questionnaires. The aim of this study was to examine the possibility of constructing a Continuity of Care Index (COCI) using register based person-level data in Finland and, additionally, to find national time trends and differences between counties. The population of interest was Finns 65 years or older.

Methods Phone calls and non-urgent visits to nurses or physicians in public primary care centres during the years 2015–2018 were extracted from the Avohilmo register. Differences in continuity were studied using national or regional means computed from patients’ individual COCIs. Statistical significance was tested using nonparametric tests.

Results COCIs could be calculated for 181 000–266 000 persons per each year. At the national level, the study revealed decreasing trends in both nurse- and physician-based means with more continuity in the latter. Data from 2018 was used to compare counties. Regional differences were found.

Conclusions Continuity of care in Finland can be measured and monitored from registers using a COCI. In some regions, identifiers of treating professionals are missing from the data, which limits the comprehensiveness of the results.