Abstract
BackgroundContinuity of general practitioner (GP) care is associated with reduced use of emergency departments, hospitalisation, and outpatient specialist services. Evidence about the relationship between continuity and use of complementary and alternative medical (CAM) providers has so far been lacking. The aim of this study was to test the association between continuity of GP care and the use of CAM providers.MethodsWe used questionnaire data from the sixth Tromsø Study, conducted in 2007–8. Using descriptive statistical methods, we estimated the proportion using a CAM provider among adults (30–87 years) who had visited a GP during the last 12 months. By means of logistic regressions, we studied the association between the duration of the GP-patient relationship and the use of CAM providers. Analyses were adjusted for the frequency of GP visits, gender, age, marital status, income, education, and self-rated health and other proxies for health care needs.ResultsOf 9,743 eligible GP users, 85.1% had seen the same GP for more than two years, 83.7% among women and 86.9% among men. The probability of visiting a CAM provider was lower among those with a GP relationship of more than 2 years compared to those with a shorter GP relationship (odds ratio [OR] 0.81, 95% confidence interval [CI] 0.68-0.96). Other factors associated with CAM use were female gender, poor health, low age and high income. There was no association with education.ConclusionsContinuity of GP care as measured by the duration of the GP-patient relationship was associated with lower use of CAM providers. Together with previous studies this suggests that continuity of GP care may contribute to health care delivery from fewer providers.
Highlights
Continuity of general practitioner (GP) care is associated with reduced use of emergency departments, hospitalisation, and outpatient specialist services
We have shown that the probability of visiting a complementary and alternative medical (CAM) provider was lower among those with a GP relationship of more than 2 years compared to those with a shorter relationship
Our main finding adds to findings that continuity of GP care is associated with reduced use of emergency departments, hospitalisation, and outpatient specialist services [9,10] (Figure 2)
Summary
Continuity of general practitioner (GP) care is associated with reduced use of emergency departments, hospitalisation, and outpatient specialist services. It is suggested to increase patient compliance [7], patient and doctor satisfaction [3,5], and comprehensiveness of care [8], and to enhance receipt of preventive services, to decrease duplication of services and the use of emergency departments [9], hospitalisation, and outpatient specialist services [10]. We defined CAM providers as “providers others than authorised health personnel who give healthrelated treatment outside the established health services.”. This definition conforms with the Norwegian law on alternative treatment [14]. Chiropractors are authorised health personnel in Norway [15], and so are not included as CAM providers in this study
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