Continuity of care for people with psychotic illness: its relationship to clinical and social functioning

Int J Soc Psychiatry. 2013 Feb;59(1):5-17. doi: 10.1177/0020764011421440. Epub 2011 Sep 23.

Abstract

Background: The relationship between continuity of care and user characteristics or outcomes has rarely been explored. The ECHO study operationalized and tested a multi-axial definition of continuity of care, producing a seven-factor model used here.

Aims: To assess the relationship between user characteristics and established components of continuity of care, and the impact of continuity on clinical and social functioning.

Methods: The sample comprised 180 community mental health team users with psychotic disorders who were interviewed at three annual time-points, to assess their experiences of continuity of care and clinical and social functioning. Scores on seven continuity factors were tested for association with user-level variables.

Results: Improvement in quality of life was associated with better Experience & Relationship continuity scores (better user-rated continuity and therapeutic relationship) and with lower Meeting Needs continuity factor scores. Higher Meeting Needs scores were associated with a decrease in symptoms.

Conclusion: Continuity is a dynamic process, influenced significantly by care structures and organizational change.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Community Health Services*
  • Continuity of Patient Care*
  • Female
  • Follow-Up Studies
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Outcome and Process Assessment, Health Care
  • Psychiatric Status Rating Scales
  • Psychotic Disorders / diagnosis
  • Psychotic Disorders / psychology
  • Psychotic Disorders / rehabilitation*
  • Quality of Life / psychology
  • Social Adjustment*