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- Title
Reexamining the Association of Care Continuity and Health Care Outcomes.
- Authors
Chi-Chen Chen; Shou-Hsia Cheng
- Abstract
OBJECTIVES: This study examined the relationship between claims-based and patient-reported continuity of care (COC) measures and investigated the effects of the 2 types of COC measures on subjective and objective health care outcomes. STUDY DESIGN: A prospective, cross-sectional, correlational survey design was used. A nationwide face-toface interview survey of community-dwelling older adults was conducted, and the survey participants' health claims records were retrieved and linked under the universal health insurance system of Taiwan in 2018. METHODS: Health care outcomes were measured subjectively (patient satisfaction and perceived lack of coordination) and objectively (likelihood of hospital admissions and emergency department [ED] visits). COC was measured using claims-based and multidimensional patient-reported COC. Ordered logit and logit models were used to examine the relationship between the 2 types of COC measures, and health care outcomes were measured subjectively and objectively. Average marginal effects with bootstrapped SEs were computed for health care outcomes. RESULTS: This study demonstrated that the correlations of claims-based and patient-reported COC measures were quite low and mainly insignificant. A higher claims-based COC was significantly associated with a lower likelihood of hospital admissions, ED visits, and perceived lack of coordination. No significant relationship was identified between claims-based COC and patient satisfaction. Participants reporting higher COC had better patient satisfaction and less perceived lack of coordination. However, no relationship was identified between patient-reported COC and the likelihood of hospital admissions and ED visits. CONCLUSIONS: The correlation between claims-based and patient-reported COC measures is low, and claims-based and patient-reported COC measures are associated with different subjective and objective health care outcomes. We suggest that claims-based COC indicators representing the pattern of physician visits might be considered a unique dimension of COC.
- Subjects
TAIWAN; EVALUATION of medical care; RESEARCH; HOSPITAL emergency services; SELF-evaluation; CROSS-sectional method; MULTIPLE regression analysis; INTERVIEWING; PATIENT satisfaction; MEDICAL care; HEALTH status indicators; CONTINUUM of care; HEALTH insurance reimbursement; SOCIOECONOMIC factors; PEARSON correlation (Statistics); PATIENTS' attitudes; INDEPENDENT living; HOSPITAL care; QUESTIONNAIRES; FACTOR analysis; DESCRIPTIVE statistics; SCALE analysis (Psychology); RESEARCH funding; STATISTICAL correlation; STATISTICAL sampling; DATA analysis software; LONGITUDINAL method; OUTPATIENT services in hospitals; EVALUATION
- Publication
American Journal of Managed Care, 2023, Vol 29, Issue 8, pe242
- ISSN
1088-0224
- Publication type
Article
- DOI
10.37765/ajmc.2023.89411