Continuity of care for people with psychotic illness: its relationship to clinical and social functioning.
Catty J., White S., Clement S., Cowan N., Geyer C., Harvey K., Jones IR., McLaren S., Poole Z., Rose D., Wykes T., Burns T.
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.