Continuity of Care and Avoidable Hospitalizations for Chronic Obstructive Pulmonary Disease (COPD)

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.