Journal
JOURNAL OF THE AMERICAN BOARD OF FAMILY MEDICINE
Volume 28, Issue 2, Pages 222-230Publisher
AMER BOARD FAMILY MEDICINE
DOI: 10.3122/jabfm.2015.02.140141
Keywords
Chronic Obstructive Pulmonary Disease; Continuity of Care; Hospitalization
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Funding
- Aim for the Top University and Elite Research Center Development Plan from National Yang-Ming University in Taiwan
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Background: Numerous studied suggest that better continuity of care could result in better health outcomes. However, few studies have examined the relationship between continuity of care and avoidable hospitalizations. Methods: A retrospective cohort study design was adopted. We used secondary data analysis based on claim data regarding health care utilization under a universal coverage health insurance scheme in Taiwan. The study population included 3,015 subjects who were newly diagnosed with chronic obstructive pulmonary disease (COPD) in 2006. The main outcome was COPD-related avoidable hospitalization, and the continuity of care index (COCI) was used to measure continuity of care. A logistic regression model was used to control for sex, age, low-income status, and health status. Results: With regard to the effects of continuity of care on avoidable hospitalizations, dose-response trends were observed. The logistic regression model showed that after controlling for covariables, subjects in the low COCI group were 129% (adjusted odds ratio, 2.29; 95% confidence interval, 1.26-4.15) more likely to undergo COPD-related avoidable hospitalizations than those in the high COCI group. Conclusions: Patients with COPD with higher continuity of care had a significantly lower likelihood of avoidable hospitalization. To prevent future hospitalizations, health policy stakeholders should encourage physicians and patients to develop long-term relationships to further improve their health outcomes.
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