• Anne Helen Hansen, Peder A Halvorsen, Ivar J Aaraas, and Olav Helge Førde.
• National Centre for Integrated Care and Telemedicine, University Hospital of Northern Norway, Tromsø, Norway. anne.helen.hanzen@gmail.com
• Br J Gen Pract. 2013 Jul 1; 63 (612): 482-9.

BackgroundContinuity of GP care is associated with reduced hospitalisations, but solid documentation of its relationship to use of outpatient specialist services is lacking.AimTo test the association between continuity of GP care and use of inpatient and outpatient specialist services.Design And SettingA cross-sectional population-based study with questionnaire data from the sixth Tromsø Study (2007-2008).MethodDescriptive statistics and two sample t-test were used to estimate specialist healthcare use according to duration of the GP-patient relationship. Logistic regression analysis was used to assess associations between duration and intensity of the GP-patient relationship and use of specialist care. Analyses were adjusted for sex, age, marital status, income, education, and self-rated health, and also stratified by self-rated health and age.ResultsOf 10,624 eligible GP users, 85% had seen the same GP for >2 years. The probability of visiting outpatient specialist services was significantly lower among these participants compared to those with a shorter GP relationship (odds ratio [OR] = 0.81, 95% confidence interval [95% CI] = 0.71 to 0.92). Similar findings were found for hospitalisations (OR = 0.76, 95% CI = 0.64 to 0.90). Stratified analyses revealed that these associations were not dependent on self-rated health or age. The probability of specialist use increased for the frequent GP users.ConclusionContinuity of GP care is associated with reduced use of outpatient specialist services and hospitalisations. Healthcare providers and policymakers who wish to limit use of specialist health care may do well to perform and organise health services in ways that support continuity in general practice.

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