# Improving continuity of care in Finnish primary health care: Insights from a nationwide qualitative study of primary care physicians

## TL;DR

This study explores how primary care physicians in Finland suggest improving continuity of care through organizational, practice-level, and digital strategies.

## Contribution

The study provides new insights from PCPs on systemic and practical approaches to enhance continuity of care in Finnish primary health care.

## Key findings

- PCPs emphasized organizational factors like health center size and work arrangements as important for COC.
- Practice-level autonomy and digital solutions, such as measuring COC data, were highlighted as key improvement areas.
- Small, incremental changes can improve COC for individual patients while larger systemic efforts are also needed.

## Abstract

Continuity of care (COC) is a core value in general practice. It has been deteriorating in Finnish primary health care, but there are now attempts to improve it.

This study focused on gathering insights of primary care physicians (PCPs) on how COC can be improved within Finnish primary health care.

We conducted a nationwide survey targeting all PCPs working in primary health care. A web-based questionnaire was sent to PCPs in Finland from May to October of 2023. The questionnaire included the question ‘How would you improve continuity of care in your workplace?’ Data were analysed using a descriptive approach that involved iterative and inductive thematic analysis.

We received a total of 291 responses from PCPs across Finland (7% response rate). We identified themes related to organisation (e.g. arrangement of practical work including the size of a health centre), practice-level (e.g. autonomy, including the opportunity to perform COC in daily work), and themes related to digital solutions (e.g. data of COC measured and available). PCPs had considerable insight into the development of COC in day-to-day operations.

Enhancing COC for a primary care patient population requires a systemic perspective and structured, goal-oriented development efforts. However, small and discrete steps can also contribute to improving COC for individual patients. Our findings highlight the link between COC enhancement and the development of the health care system as a whole.

Improving continuity of care is closely linked to the overall development of the health care system

This study proposes organisational, practice-level, and digital strategies to improve continuity of care

Primary care physicians can contribute significantly, drawing on their clinical experience and systemic understanding of health care