Impact of primary care physician continuity on survival in patients with atrial fibrillation: a retrospective cohort study

OBJECTIVE: To assess the impact of Continuity of Care (COC)-care provided by the same Primary Care Physician (PCP)-on outcomes in patients with atrial fibrillation (AF). METHODS: We conducted a retrospective cohort study including all patients with AF referred by PCPs (n=17,889) between January 2010 and December 2023 in the Santiago de Compostela healthcare area (Spain). COC was categorized as "PCP stability" (care by the assigned PCP) or "interrupted COC" (care by multiple rotating PCPs). The association between COC and outcomes (hospitalization, mortality, stroke, and haemorrhage) was estimated using Cox regression and Fine-Gray competing risk models, adjusted for potential confounders. RESULTS: Patients with PCP stability had a significantly lower annual referral rate (1.5 vs. 1.8, p