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GP cooperatives were perceived to have many strengths, but reduced continuity of care was mentioned as a possible weakness.
The weaknesses most commonly identified by survey participants were reduced continuity of care (25.7% of respondents); increased handoff frequency (16.8%); reduced intern preparedness for more senior positions (9.4%); that the new DHR promoted the adoption of a "shift mentality" (8.9%); and that the new DHR brought with it a disproportionate increase in the senior resident workload (8.4%).
This episodic approach encouraged by data collection and monitoring requirements reduced continuity (seen as important for care planning) and is seen as further exacerbated by fragmentation of services and roles within services.
Too drastic a shift in favour of access is likely to be at the cost of reduced continuity and a diminution of other services, such as screening and chronic disease management.
17 A US study shows that reduced continuity of care with paediatric patients on Medicaid or with asthma was associated with increased EHA, and one study carried out in Manitoba, Canada showed that high continuity of care was associated with a reduction in EHA.
Primary care-based research may be particularly important; for example, there is evidence of reduced continuity of care in general practices in the UK, 25 27 but we do not yet know how this fragmentation of care impacts on the health and healthcare experience of patients with multiple long-term conditions.
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Those planning primary care services, and those providing them, should avoid policies that reduce continuity of care.
Our FRAP analysis clearly shows that ER with a fragmented appearance constitutes ER with broken or much reduced lumenal continuity after glutamate (Fig. 2A) or NMDA (Fig. 2B) treatment.
This reduces the continuity of the Weyl product to the continuity of certain infinite-dimensional matrix operators.
These will reduce the continuity and stability of the powder flow and is unfavorable for improving the density or uniformity of the layered powder bed.
An important complication arising from weakly wetting conditions is the absence of wetting films, which strongly reduces the continuity of the phases throughout the network.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com