Does continuity of care matter in a health care system that lacks referral arrangements?
Does continuity of care matter in a health care system that lacks referral arrangements?
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DOI：
10.1093/heapol/czq035
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发表时间：
2011-03-01
影响因子：
3.2
通讯作者：
Chen, Chi-Chen
中科院分区：
文献类型：
--
作者：
Cheng, Shou-Hsia;Hou, Yen-Fei;Chen, Chi-Chen
方法研究对象为2005年就诊4次及以上的134422名受试者。采用负二项回归分析了三种不同的COC指数对2005年和随后一年(2006)的住院和急诊人数的影响。结果数据表明，在我们的研究人群中，COC较低与住院和急诊的增加有关。2005年，与高COC组相比，低COC组和中等COC组的住院人数分别增加了42-82%和39-46%，急诊就诊人数分别增加了75%-102%和41%-45%。在接下来的几年中，COC的保护作用也较弱。结论本研究表明，即使在缺乏转诊安排框架的医疗保健系统中，COC较低也与住院和急诊就诊的增加有关。这表明，改善COC对患者和医疗保健系统都是有益的。
Methods The study population included a total of 134 422 subjects who made four or more visits to physicians in 2005. Negative binominal regressions were performed to examine the effects of three different COC indices on the numbers of hospital admissions and ED visits in 2005 and in the subsequent year (2006).Results The data suggest that lower COC was associated with increased hospital admissions and ED visits in our study population. Compared with the high COC group, subjects in the low and medium COC groups had 42-82% and 39-46% more hospital admissions, respectively, as well as 75-102% and 41-45% more ED visits, respectively, in 2005. Weaker protective effects of COC were also observed in the subsequent year.Conclusions This study indicates that lower COC is associated with increased hospital admissions and ED visits, even in a health care system that lacks a referral arrangement framework. This suggests that improving the COC is beneficial both for patients and for the health care system.