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Longitudinal care continuity and avoidable hospitalization: the application of claims-based measures
Shou-Hsia Cheng1,2, Chi-Chen Chen3, Yueh-Yun Lin4
1Institute of Health Policy and Management, College of Public Health, National Taiwan University, Room 618, 17, Hsu-Chow Road, Taipei, 100, Taiwan. shcheng@ntu.edu.tw.
BMC Health Services Research
|May 27, 2023
Summary
Continuity of care (COC) is crucial for patient health. This study introduces a new measure, the provider duration continuity index (PDCI), using claims data, showing it impacts avoidable hospitalizations.
Area of Science:
- Health Services Research
- Health Informatics
- Public Health
Background:
- Continuity of care (COC) is vital for patient-physician relationships.
- Traditional COC measures rely on patient surveys.
- This study introduces a novel approach using longitudinal claims data.
Purpose of the Study:
- To develop and validate a provider duration continuity index (PDCI) using claims data.
- To assess the agreement between PDCI and existing COC measures.
- To investigate the impact of different COC measures on avoidable hospitalizations across comorbidity levels.
Main Methods:
- Utilized a 4-year panel of nationwide health insurance claims data (2014-2017) in Taiwan.
- Analyzed 328,044 patients with at least 3 physician visits annually.
- Constructed two PDCIs and compared them with three established COC indicators using correlation analysis and generalized estimating equations.
Main Results:
- High correlations were observed among traditional COC indicators (γ = 0.787–0.958).
- Moderate correlation was found between the two PDCI measures (γ = 0.577–0.579).
- Low correlations existed between traditional COC indicators and PDCIs (γ = 0.001–0.257), indicating distinct measurement domains. All COC measures demonstrated protective effects against avoidable hospitalizations.
Conclusions:
- Physician-patient interaction duration, measured by PDCI, is an independent and significant factor in assessing COC.
- PDCI offers a valuable, data-driven perspective on continuity of care.
- Effective COC measurement, including duration, is linked to improved healthcare outcomes and reduced hospitalizations.
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