Continuity of Care and Patient Outcomes in Populations With Schizophrenia: A Systematic Review.

OBJECTIVE: Previous systematic reviews have assessed associations between care continuity and health outcomes broadly and specifically for individuals with mental illness. However, little is known about this relationship for individuals with schizophrenia, who may experience substantial barriers to care. This study aimed to systematically review and compare estimates of associations between continuity of care (CoC) and outcomes for individuals with schizophrenia. METHODS: The authors searched PubMed and PsycInfo for articles published in English between database initiation and January 8, 2025, by using search terms related to CoC and outcomes for adults with schizophrenia and related psychotic disorders. Inclusion criteria required measurement of associations between a quantitative measure of CoC and an outcome. RESULTS: Twenty-nine studies were included, over half of which were published after 2013. More than 60% reported a positive association between increased CoC and improved outcomes. Service continuity was the most widely used CoC measure, with 67% (k=8 of 12) of these studies finding an association with improved outcomes. Approximately two-thirds of studies evaluated hospitalizations as an outcome, with 47% (k=9 of 19) of these studies finding an association with improved outcomes. CONCLUSIONS: Studies varied widely with regard to CoC measures and outcomes measured. Although many studies found a positive association between increased CoC and improved outcomes, this result was not universal. Differences may have stemmed from measurement issues and differences in associations based on populations, service types, and other key study factors. The findings suggest a potential need for standardized CoC measures that can be monitored in clinical practice.