Patients' perceptions of interpersonal continuity of care.

PURPOSE: The health system shift from doctor-patient continuity of care to team-based continuity may not match patients' preferences. This article reviews the existing medical literature regarding patients' perceptions of interpersonal continuity of care to determine which patients value interpersonal continuity and in what context. METHODS: A search of the ISI Web of Knowledge database from 1970 to April 2005 and the MEDLINE database from 1966 through April 2005 was performed to find articles that elicited patients' preferences or value for continuity of care. Thirty six articles were used for this synthesis. RESULTS: Interpersonal continuity of care is important to a majority of patients, particularly those from vulnerable groups. Patients value the relationship with their physician, their physician's knowledge about them, and the ability to communicate their concerns. Over time, contact with a physician seems to lead to the development of trust and confidence. However, continuity of care is not valued by all patients or across all settings. CONCLUSIONS: Future research should continue to explore the importance of interpersonal continuity to patients. In particular, are there medical consequences when those whom desire continuity do not receive it? Clinicians should consider incorporating patients' preference for continuity into their office scheduling procedures.