Continuity of care for patients with chronic conditions from rural or remote Australia: A systematic review.
Tamara D Street, Klaire Somoray, Georgia C Richards and 1 others
PMID 31074919WHAT IT FOUND
Care for rural and remote patients with chronic conditions often breaks when discharge notes, referrals or advice are incomplete or inconsistent.
Better communication between providers and regular patient contact were reported to support continuity.
Key findings
01Inconsistent management between metropolitan and rural services, or between local providers, was reported as a barrier to continuity, often arising from poor discharge planning and referral systems.
02Poor documentation and incomplete discharge summaries were associated with fragmented care and poor outcomes; incompatible systems and lack of service awareness also worsened discharge planning.
03Good communication between professionals, regular patient contact, and a dedicated coordination role were reported as facilitators of collaborative care.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review included heterogeneous studies, many qualitative or pilot designs, so it cannot show how much any single intervention improves continuity. It did not combine results to show how large any improvement was. The supplied text says bias was assessed but does not report the results, so study quality is unclear. The evidence came from Australian rural and remote settings, so transfer to other systems may be limited. Some included studies focused on providers rather than patient outcomes.
Declared interests
The authors declared no conflict of interest.
The easy way to misread this
Do not read the review as proof that any component, such as telemedicine or a care coordinator, improves patient outcomes. The review synthesised reported experiences and themes, and the included programmes often delivered many components together.