Familiarity breeds neglect? Unanticipated benefits of discontinuous primary care
Date
2003
Authors
Broom, Dorothy
Journal Title
Journal ISSN
Volume Title
Publisher
Oxford University Press
Abstract
Background. Continuity of medical care is generally considered to be beneficial to patients. Objective. The aim of this study was to investigate the possibility that familiarity with patients may sometimes discourage case finding. Methods. Extensive qualitative interviews were carried out with a sample of Australian adults with type 2 diabetes, focusing in particular on their experience of diagnosis. Results. Interviews were conducted with 119 participants, 75% of whom supplied sufficient information to enable the coding of whether diagnosis occurred under circumstances of discontinuity. Half of all participants (two-thirds of the coded subsample) had a diagnosis that could be categorized as resulting from discontinuous primary care: hospital admission, change of doctor, patient initiative and/or diabetic emergency. Conclusion. The same circumstances that enhance the management of chronic disease can at times hinder its diagnosis. Primary care service providers may need to instigate more active methods of case finding in order to avoid this paradoxical effect of familiarity with the patient.
Description
Keywords
Keywords: adult; aged; article; Australia; case finding; chronic disease; doctor patient relation; emergency health service; experience; female; hospital admission; human; interview; major clinical study; male; non insulin dependent diabetes mellitus; patient compl Diabetes; Diagnosis; Primary care
Citation
Collections
Source
Family Practice
Type
Journal article