Continuity

The degree to which a patient experiences a series of discrete healthcare events as coherent and consistent with their medical needs and personal context. This requires fostering trusted relationships between health care providers and patients over time (relational continuity), ensuring information is communicated from one event to the next (informational continuity), and ensuring the process is managed in a timely, complementary, and effective way across providers (management continuity).

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Timeliness

The ability of the health system to provide primary care services to patients when they need them, with acceptable and reasonable wait times and at days and times that are convenient to them.

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Safety

The practice of following procedures and guidelines in the delivery of PHC services in order to avoid harm to the people for whom care is intended.

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Efficiency

Efficiency refers to the ability of a health system to attain its desired objective(s) with the available resources, while minimizing waste and maximizing capacities to deliver care to those who need it.

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Effectiveness

Effectiveness measures whether health care and services are driven by evidence, adhere to established standards, and achieve their intended result.

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People-Centeredness

People-centeredness means organizing the health system around the comprehensive needs of people rather than individual diseases.

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First Contact Accessibility

The capacity of a primary care system to serve as the first point of contact, or a patient's entry point to the health system, for most of a person's health needs.

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Coordination

Coordination of care refers to the system's ability to oversee and manage patient care over time and across levels of care to ensure appropriate follow-up, minimize the risk of error, and prevent complications.

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Continuity

Continuity is the degree to which a patient experiences a series of discrete healthcare events as coherent and consistent with their medical needs and personal context.

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Comprehensiveness

The provision of holistic and appropriate care across promotive, preventive, curative, rehabilitative, chronic and palliative service needs.

Indicators
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Patient-reported experiences
Related Concepts

Delivering high-quality primary health care requires many elements of the health system working effectively together. This mapping explores how different concepts with the framework relate to one another.

Upstream elements are those that are required to develop or improve a particular concept. Absence or poor performance of an upstream element is expected to negatively impact the performance of the concept of focus.

Complementary elements are those where improvements or developments in this area will be mutually beneficial to the concept of focus but not required for improvement.

UPSTREAM CONCEPTS
COMPLEMENTARY CONCEPTS
UPSTREAM SUBDOMAINS
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Information & Technology
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Population Health Management
Continuity
COMPLEMENTARY SUBDOMAINS
PHC Workforce
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Achieving continuous PHC requires a workforce that is trained to provide a broad set of services across the life course.
Access
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Timely, geographic, and financial access can compliment a patient's ability to receive continuous care overtime when they need it.
Coordination
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Management continuity and coordination of care are closely related concepts. Care coordination mechanisms such as patient pathways and patient care plans support management continuity.
Management of Services
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Quality management infrastructures ensure quality interventions such as standardized care plans, diagnostic protocols, accreditation systems, etc. are in place across providers and facilities, promoting a continuous and coordinated care experience.
Organization of Services
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Interoperable systems of referral compliment can aid in a patient experiencing transfers of care between PHC levels and facilities as coherent and connected.
People-Centeredness
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Person-centered care and development of respect and trust between patient and provider helps to advance relational continuity.
Resilient Facilities and Services
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Assessing resilience of services can help promote continuity of care during times of public health emergency.
Service Availability & Readiness
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Respect and trust between providers and patients can improve communication and provider motivation and contribute to the formation of continuous relationships over time.
Timeliness
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Timeliness of care can help promote relationship continuity between patient and their provider and/or facility.
Improvement Strategies

Each PHCPI Improvement Strategy is designed to help decision-makers begin to plan and enact reforms within their own context by providing additional resources and evidence on the topic, as well as practical recommendations for action.

The explainer graphic below presents a quick overview of the concept of Continuity. View the full Improvement Strategy on Primary Care Functions to learn more.

Continuity explainer graphic
Potential Funding opportunities

Interested in understanding how this topic intersects with investment opportunities from major funding streams? The Global Frameworks Mapping provides a starting point to help identify and make connections between key PHC topics, relevant funding initiatives, and investment cases.

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Walking the Talk: Reimagining Primary Health Care After COVID-19
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Strategy for quality health infrastructure in Africa 2021-2030
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Phase V (2021-2025)
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HIV