IMPACT OF CONTINUITY OF CARE ON CARE AND COSTS FOR CHRONIC DISEASE
Author(s)
Cheng J, Ku H
Chang Gung University, Tao-Yuan, Taiwan
OBJECTIVES: Continuity of care is an important public health issue worldwide. The quality of care may be compromised due to lack of coordinated care, particularly for individuals with chronic diseases who need intensive and comprehensive care. Furthermore, medical costs may increase due to suboptimal and duplicate care. Therefore, this study aimed to examine the impact of continuity of care on medical care and costs of those with chronic diseases. METHODS: The National Health Insurance claims database of a representative sample of Taiwanese population was adopted for this study. Adult individuals who had outpatient visits for heart failure, hypertension, diabetes mellitus, hyperlipidemia, chronic obstructive pulmonary disease, or asthma were included. Their use of medical care in the first year of follow-up was adopted for estimating continuity of care index. Their use and costs of health services in the second year were used to measure medication possession ratio, admission to hospital or emergency department, and disease-related costs. Logistic regression models and generalized linear models were adopted for analyses. RESULTS: The mean age of the subjects in each disease ranged from 46 to 64, and 49%-62% of the subjects in each disease were male. Individuals with higher continuity of care index were more likely to adhere to their medication regimen, and had a lower probability of being admitted to emergency department or hospital. In individuals with heart failure, diabetes mellitus, and chronic obstructive pulmonary disease, higher continuity of care index led to lower total cost. CONCLUSIONS: This study identified the impact of continuity of care on the care and costs of medical services for chronic diseases. Better continuity of care led to better medical adherence and a lower risk of being admitted to hospital or emergency department.
Conference/Value in Health Info
2016-10, ISPOR Europe 2016, Vienna, Austria
Value in Health, Vol. 19, No. 7 (November 2016)
Code
PHS133
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Cardiovascular Disorders, Diabetes/Endocrine/Metabolic Disorders, Respiratory-Related Disorders