More health and happiness: the continuity of care at Terveystalo is at an excellent level

The Continuity of Care Index (COCI) measures the dispersion of the patient’s appointments with different professionals on a scale from 0 to 1 over a specific period of time. If the patient meets with a different physician almost every time, the index is close to zero. If, on the other hand, the patient always meets the same expert, the value is 1.

Terveystalo’s COCI has now been published for physicians’ appointments at the clinic and booked remote appointments, and it consists of the largest specialties, such as geriatrics, psychiatry, internal medicine and neurology. The index is presented by specialty because, unlike in a health care center, patients seek appointments directly with a physician of a certain specialty.

When the largest specialties are added together, Terveystalo's COCI is 0.8. In Finnish primary health care, the COCI typically falls between 0.28 and 0.3, whereas the best units in the world reach a range of 0.7 to 0.8.

“Continuity of care is important, especially in the treatment of the elderly and in the treatment of long-term illnesses, such as diabetes or depression. In geriatrics, for example, our index score is very close to one. The figures are also very good in, for example, pulmonary diseases, rheumatology, gastroenterology, surgery and psychiatry,” says Terveystalo's Chief Quality Physician Antti-Jussi Ämmälä.

“The COCI of general practitioners and occupational health physicians is lower because customers also seek their help in acute situations where the choice of the professional is particularly affected by the appointments available. In preventive occupational health care, the continuity of care is realised well,” Ämmälä continues.

The COCI collects data over a period of two years. The data collected shows how many times the patient has had an appointment and, out of these appointments, how many times they have visited the same physician. 

“In order for the indicator to be reliable, the customer must have at least three visits over the course of two years and a choice of several physicians. We are specifically looking for longer-term treatment relationships, which can be found, for example, in the treatment of diabetes and rheumatic diseases. If you have a couple of appointments per year because you have the flu, it doesn’t really matter which physician you see,” Ämmälä says.

Continuity of care benefits both the customer and the professional

“Continuity of care has been shown to have a connection with better treatment outcomes, less frequent visits to the emergency room and a lower level of morbidity and mortality, in other words several important indicators of the quality of care,” says Ämmälä.
According to several studies, both patients and professionals value long-term doctor-patient relationships.

“When a patient is able to see a familiar professional, they don’t need to run through their entire medical history and life at the beginning of each appointment; the time can be used to take care of the matter at hand. A familiar professional often evokes a feeling of trust and safety and improves the patient’s commitment to treatment.”

“The professional, in turn, is able to see the impact of care. In long-term doctor-patient relationships, the professional has significantly better changes of having an impact. After all, health is not a thing that can be transformed in a single appointment. When a patient says that they have not smoked in two months, for example, it’s also rewarding for the professional,” Ämmälä concludes.

Terveystalo publishes the COCI as part of a broader set of quality indicators. See the data on Terveystalo’s web page on quality indicators.