The great advances that medicine has achieved since the nineteenth century derive from research and better knowledge of pathophysiological problems, their prevention and treatment. However, research and improvements are focused on treating physical factors, while the human aspects of health care have been forgotten. A new study has given this aspect of medicine the importance it deserves.
A recent publication in the medical journal ‘BMJ Open’ points out the relationship between the continuity of medical care and treatment and the mortality of patients, stating that the risk of mortality in any circumstance decreases the longer regular medical care is prolonged. These conclusions would directly contradict the claims made by an editorial in the ‘New England Journal of Medicine’ , which stated that non-personal care should be ‘the default option’ in medicine.
Continuity of care, as defined by the team responsible for the work, is the repeated contact between a patient and their doctor . Starting from this point, the team led by DJ Pereira Gray has compiled information from various studies and previous scientific works to answer the question ‘Are the highest levels of continuity in medical care, in any situation, with any group of patients? patients, associated with a change in mortality? ‘
With a total of 726 studies and publications dealing with medical care or mortality, the team made a selection of 43 that needed to be reviewed for research. After ruling out those in which continuity was not measured, in which treatment was not done by a single doctor or group of doctors, and in which mortality was not analyzed at any time; the research was narrowed down to 22 studies that fell within the desired parameters. The team proposed measures to counter the risk of bias during the process and used the Newcastle-Ottawa Scale , designed to ensure the quality of a non-randomized scientific study.
Research findings
Of the 22 results, 18 (81.8% of the total) showed a clear direct relationship between greater continuity of care and lower mortality after these, pointing out in 16 of them that mortality from any cause was reduced. Three other studies did not show any relationship between care and mortality , although the time scales in which they were developed were too short or the methods used were insufficient to be able to analyze the effects of the doctor-patient relationship . Finally, a single study showed contradictory results according to the type of continuity measures used, so despite being the only study that contradicts the others, it is not conclusive.
Research reveals that continuity of care can bring great benefits to patients in the long term. The relationship between doctor and patient over time will generate greater involvement by both parties that will ensure compliance and control of the treatment being followed. In addition, this follow-up will increase patient satisfaction , and this will generate a positive attitude that will affect their health.
Although the great advances in medicine come at the hands of technology, human treatment remains a linchpin and a matter of life and death.
Referencia: Pereira Gray DJ, Sidaway-Lee K & White E. ‘Continuity of care with doctors—a matter of life and death? A systematic review of continuity of care an mortality. BMJ Open, 2018. DOI: 10.1136/bmjopen-2017-021161
Although the great advances in medicine come at the hands of technology, human treatment remains a linchpin and a matter of life and death.
Reference: Pereira Gray DJ, Sidaway-Lee K & White E. ‘Continuity of care with doctors — a matter of life and death? A systematic review of continuity of care an mortality. BMJ Open, 2018. DOI: 10.1136 / bmjopen-2017-021161
