Cost effectiveness of continuity in general practice

Bhopal says that prevention and better primary care are unlikely to save money.1 He undervalues general practice—if diseases such as diabetes and hypertension are detected early, they can be managed entirely within general practice.Furthermore, continuity of care, a feature of good general practice, is significantly associated with reductions in hospital admissions and use of emergency departments. Barker and colleagues2 found that an increase of 0.2 on the usual provider of care index of GP continuity was associated with a 6.2% reduction in hospital admissions for older people. Delgado and colleagues3 confirmed this finding for patients with dementia who might be expected to have low admission rates. Emergency hospital admissions are one of the most expensive elements of NHS care, and for older people, each one on average costs over £8000.Several studies45 have shown that continuity of GP care is associated with reduced overall costs in the health system. Policy makers…
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