I-Po Lin1, Shiao-Chi Wu2. 1. Department of Health Care Administration, Oriental Institute of Technology, No. 58, Sec 2, Sihchuan Rd., Banqiao District, New Taipei City, 22061, Taiwan, ROC. Electronic address: FL002@mail.oit.edu.tw. 2. Institute of Health and Welfare Policy, National Yang-Ming University, No. 155, Sec 2, Linong Street, Taipei, 112, Taiwan, ROC. Electronic address: scwu@ym.edu.tw.
Abstract
OBJECTIVE: To examine the effects of high continuity of care (COC) maintained for a longer time on the risk of avoidable hospitalization of patients with chronic obstructive pulmonary disease (COPD). METHODS: A retrospective cohort study design was adopted. We used a claim data regarding health care utilization under a universal health insurance in Taiwan. We selected 2199 subjects who were newly diagnosed with COPD. We considered COPD-related avoidable hospitalizations as outcome variables. The continuity of care index (COCI) was used to evaluate COC as short- and long-term COC. A logistic regression model was used to control for sex, age, low-income status, disease severity, and health status. RESULTS: Long-term COC had stronger effect on health outcomes than short-term COC did. After controlling for covariables, the logistic regression results of short-term COC showed that the medium COCI group had a higher risk of avoidable hospitalizations (adjusted odds ratio [AOR]: 1.89, 95% CI: 1.07-3.33) than the high COCI group did. The results of long-term COC showed that both the medium (AOR: 1.98, 95% CI: 1.0-3.94) and low (AOR: 2.03, 95% CI: 1.05-3.94) COCI groups had higher risks of avoidable hospitalizations than did the high COCI group. CONCLUSIONS: Maintaining long-term high COC effectively reduces the risk of avoidable hospitalizations. To encourage development of long-term patient-physician relationships could improve health outcomes.
OBJECTIVE: To examine the effects of high continuity of care (COC) maintained for a longer time on the risk of avoidable hospitalization of patients with chronic obstructive pulmonary disease (COPD). METHODS: A retrospective cohort study design was adopted. We used a claim data regarding health care utilization under a universal health insurance in Taiwan. We selected 2199 subjects who were newly diagnosed with COPD. We considered COPD-related avoidable hospitalizations as outcome variables. The continuity of care index (COCI) was used to evaluate COC as short- and long-term COC. A logistic regression model was used to control for sex, age, low-income status, disease severity, and health status. RESULTS: Long-term COC had stronger effect on health outcomes than short-term COC did. After controlling for covariables, the logistic regression results of short-term COC showed that the medium COCI group had a higher risk of avoidable hospitalizations (adjusted odds ratio [AOR]: 1.89, 95% CI: 1.07-3.33) than the high COCI group did. The results of long-term COC showed that both the medium (AOR: 1.98, 95% CI: 1.0-3.94) and low (AOR: 2.03, 95% CI: 1.05-3.94) COCI groups had higher risks of avoidable hospitalizations than did the high COCI group. CONCLUSIONS: Maintaining long-term high COC effectively reduces the risk of avoidable hospitalizations. To encourage development of long-term patient-physician relationships could improve health outcomes.