Continuity of hospital care: beyond the question of personal contact

Patients' experiences have placed continuity of hospital care on the agenda in Norway1 as in other countries. 2 3 Although continuity of care has a long history in the literature of primary care,4^–9 the concept is not often related to hospital care. Most of such publications deal with long term hospitalisation,10 psychiatry,11 and nursing12 and focus on personal continuity—where one clinician is responsible for each patient. The reality of acute treatment and care in the hospital environment is ignored, and there is confusion over the concept of continuity of hospital care. 13 14

Continuity of care is important for patients' satisfaction in primary and hospital care. 1 15 To compensate for the fragmented nature of specialised hospital care, many hospitals try to imitate primary care by designating one carer to a particular patient. This kind of personal continuity is important, but it does not ensure that patients receive the best treatment during their hospital stay. It is important to recognise that continuity of care when the carer is an institution differs in important aspects from continuity when the carer is a person.

We discuss continuity in relation to the fact that hospital care is an organised, multidisciplinary, …