Annals of Family Medicine: Two New Studies Examine Continuity of Care in Home-Based Primary Care and Patient Preferences

One study of adults receiving home-based primary care found that greater continuity of care was associated with a lower likelihood of home ambulance services, emergency department visits, and hospital admissions. Another study examined patient preferences for visit type, speed of care, and continuity with their primary care physician.

PROVIDENCE, R.I. , Jan. 28, 2026 /PRNewswire/ — Continuity of care is a defining feature of primary care. It refers to patients seeing and communicating with the same clinician, or care team, over time. That ongoing relationship can shape how patients experience care and how they use health services. Two studies published in the Annals of Family Medicine examine continuity in different contexts, including how continuity is associated with emergency and hospital service use among people receiving primary care at home, and how patients weigh seeing their own clinician alongside access and speed of care.

How Continuity Relates to Emergency and Hospital Use in Home-Based Care

In a population-based cohort study using electronic health record data from three primary health care centers in Barcelona, Spain, researchers analyzed 1,207 adults receiving permanent home-based primary care over a 12-month period. Patients had an average age of 88.5 years, and most had multiple chronic conditions. Continuity was measured as the proportion of visits, including telephone consultations, that patients had with their assigned general practitioner and primary health care nurse.

Compared with patients who had less than 50% continuity with their physician, seeing the assigned general practitioner for at least three out of four visits (≥75% continuity) was associated with a 31% lower hazard of home ambulance services, a 39% lower hazard of emergency department visits, and a 35% lower hazard of hospital admissions. For primary health care nurses, continuity of care was associated with a 31% lower hazard of home ambulance services and a 38% lower hazard of hospital admissions.

Patient Preferences for Visit Type, Speed, and Seeing Their Own Physician

Researchers from the University of Michigan analyzed 2,268 survey responses from adult patients in an academic family medicine clinic. Patients were asked to consider six common health concerns, such as new symptoms, medication questions, or mental health concerns, and choose among care options that varied by visit type, timing, and clinician. Options included a portal message with their own primary care physician within three days, a video visit with another physician in three to seven days, a video visit with their own physician in two weeks, or an in-person visit with their own physician in six weeks. Across all six scenarios, patients most often preferred a portal message from their own primary care physician within three days. A video visit with another clinic doctor in 3-7 days was consistently the second choice. The authors note important limitations, including that the study was conducted in a single care setting and may not be generalizable to all patient populations or health systems.

Primary care continues to evolve in complex ways. In patients receiving home-based care, higher continuity with assigned clinicians was associated with a lower likelihood of home ambulance services, emergency department visits, and hospital admissions. In a separate study, patient preference research shows that individuals place high importance on timely access, convenience, and rapid communication, as well as continuity with their primary care physician. Together, these findings highlight the challenge for primary care systems of supporting both continuity with trusted clinicians and timely access in ways that are sustainable for practices.

Articles Cited:

Effect of Continuity of Care on Emergency Care and Hospital Admissions Among Patients Receiving Home-Based Care: A Population-Based Cohort Study

Carmen Herranz, MSc, PhD; Luis González-de Paz, MSc, PhD; Alicia Borrás-Santos, MPH, PhD; Sofía Alvarez, RP; Bibiana Contreras, MD; Nuria García, RN; Elena Gómez, RN; Marta Navarro, MD; Amaya Serna, RN; Silvia Roura-Rovira, MSc; Jaume Benavent-Àreu, MD; and Antoni Sisó-Almirall, MD, PhD

Patient Valuation of Visit Types, Speed of Care, and Continuity With Primary Care Physicians: A Discrete-Choice Survey

Katherine J. Gold, MD, MSW, MS; Dongru Chen, MS; John Holkeboer, BA; Gregory Shumer, MD, MHSA; Lauren Marshall, MPH, MPP; Devon Kinney, MSQM; and Ananda Sen, PhD

Annals of Family Medicine is an open access, peer-reviewed, indexed research journal that provides a cross-disciplinary forum for new, evidence-based information affecting the primary care disciplines. Launched in May 2003, Annals of Family Medicine is sponsored by six family medical organizations, including the American Academy of Family Physicians, the American Board of Family Medicine, the Society of Teachers of Family Medicine, the Association of Departments of Family Medicine, the Association of Family Medicine Residency Directors, and the North American Primary Care Research Group. Annals of Family Medicine is published online six times each year, charges no fee for publication, and contains original research from the clinical, biomedical, social, and health services areas, as well as contributions on methodology and theory, selected reviews, essays, and editorials. Complete editorial content and interactive discussion groups for each published article can be accessed for free on the journal’s website, www.AnnFamMed.org.

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SOURCE Annals of Family Medicine