Entry into long-term care disrupts primary care continuity-but only at entry: a national cohort study of transitional and post-entry continuity in facility- and home-based care in Australia.

Authors

Johannes Schwabe, Brian W Pulling, Gillian E Caughey, Maria Crotty, Helena Williams, Andrew Kellie, Gillian Harvey, David Roder, Krystal-Lee Nixon, Janet K Sluggett, Monica Cations, Tiffany K Gill, Jyoti Khadka, Megan Corlis, Carolyn Dawkins, Marilyn von Thien, Maria C Inacio

Published in

Family practice. Volume 43. Issue 6. Oct 06, 2026.

Abstract

Continuity of primary care is central to older adults' health and wellbeing, but entry into long-term care can disrupt established care relationships.
This study aimed to characterize how continuity of care evolves across the transition into long-term care and the post-entry period, comparing facility-based and home-based care, with analyses stratified by metropolitan and non-metropolitan location.
A national cohort study of Australians aged ≥65 who entered long-term care in 2019 and had at least three primary care visits within 6 months was conducted. Transitional continuity was defined by whether individuals continued seeing their pre-entry provider. Post-entry continuity was measured using the Usual Provider Index. Cohort differences were examined using regression models.
Among 69 081 entrants (home-based = 27 915; facility-based = 41 166), 72% of those entering facilities changed to a new provider, compared with 10% in home-based long-term care, p < .001. In facility-based long-term care, switching to a new provider was more common in metropolitan areas than in non-metropolitan areas. Post-entry continuity was high in both settings, with 78%-80% of visits delivered by a usual provider.
Entry into facility-based long-term care substantially disrupts established primary care relationships, but continuity is rapidly re-established after entry. The greater disruption observed in metropolitan areas suggests that factors beyond relocation, such as primary care availability and delivery models, shape transitional continuity. These findings identify long-term care entry as a key intervention point while indicating that post-entry care models effectively consolidate continuity.

PMID:
42885773
Bibliographic data and abstract were imported from PubMed on 16 Oct 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.