OBJECTIVES: Continuity of care is important for individuals with chronic obstructive pulmonary disease (COPD), as coordinated and comprehensive care is critical for COPD disease management. Suboptimal and duplicate care can lead to deteriorating conditions and increasing medical costs. Therefore, this study aimed to identify factors associated with continuity of care in the early phase of disease management, and examine the impact of continuity of care on risk of emergency room visit or hospital admission, and medical costs in individuals newly diagnosed with COPD.

METHODS: Adult subjects who were newly diagnosed with COPD and had at least four outpatient visits for COPD were selected from the National Health Insurance claims database. Continuity of care index was calculated based on their outpatient visit patterns during the first year after the initial COPD diagnosis. Their use and costs of health services during the second year were measured according to their emergency room visit, hospital admissions, and medical costs of this period. Logistic regression model and generalized linear model were adopted for analyses.

RESULTS: Of those newly diagnosed with COPD, the mean age was 56 years old, and the majority was male. Older age, male, living in rural area, and poverty were associated with lower continuity of care. Those with better continuity of care were less likely to be admitted to emergency room or hospital, and incurred lower medical costs.

CONCLUSIONS: This study identified factors associated with patterns of continuity of care in individuals newly diagnosed with COPD. The information is of importance for planning interventions to improve continuity of care, as it was demonstrated that better continuity of care contributed to a lower risk of emergency room visit or hospital admission, and lower medical costs.