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Continuity of care vital for patients with serious mental illness

Patients with a serious mental illness who have a care plan are nearly 40% less likely to be admitted to a hospital for their condition, according to results of an observational cohort study published in Health Services Research. Researchers also emphasized the importance of continuity of care for these patients by seeing the same general practitioners.

“Continuity of care through a care plan or seeing the same doctor means that doctors are able to pick up on problems quickly and understand a patient’s needs better,” Rowena Jacobs, PhD, of the Centre for Health Economics at the University of York in England, said in a press release. “Having to repeatedly explain comorbid conditions and background information to a new GP at each doctor’s appointment can be incredibly daunting and stressful for these patients.”

According to Jacobs and colleagues, continuity of care is widely believed to benefit patients with long-term conditions, including serious mental illness, as it facilitates better provider-patient relationships and reduces fragmentation of care. The researchers investigated whether continuity of care in family practice reduces unplanned hospital use for patients with serious mental illness.

To do so, they used discrete-time survival analysis for ED presentations and unplanned admissions for serious mental illness and ambulatory care-sensitive conditions. Specifically, they explored two aspects of continuity of care — care plans and consistently seeing the same GP. They defined care plans as documents that include patients’ needs, patterns of relapse, preferences for treatment and social context, all of which are accessible by different practitioners seeing the same patient.

The researchers found that among nearly 20,000 patients, higher relational continuity was associated with an 8% to 11% lower risk of ED presentation and a 23% to 27% lower risk of ambulatory care-sensitive conditions admissions. Further, care plans were associated with a 29% lower risk of ED presentation, a 39% lower risk of serious mental illness admissions and a 32% lower risk of ambulatory care-sensitive conditions admissions. Seeing the same GP reduced the risk for an unplanned hospital admission by approximately 25%, they noted.

“Finding ways to improve health care and outcomes for patients with [serious mental illness] is a high priority,” Jacobs said. “Seeing a GP is often the only regular point of contact with health services for this group and so it’s really important that they receive high-quality care at this stage of the system.” – by Joe Gramigna

Disclosures: The authors report no relevant financial disclosures.