Document Type

Article

Peer Reviewed

1

Publication Date

12-22-2014

NLM Title Abbreviation

PLoS One

Journal/Book/Conference Title

PLoS One

PubMed ID

25531108

DOI of Published Version

10.1371/journal.pone.0115088

Total Pages

18

Abstract

Background

Continuity of medical care is widely believed to lead to better health outcomes and service utilization patterns for patients. Most continuity studies, however, have only used administrative claims to assess longitudinal continuity with a provider. As a result, little is known about how interpersonal continuity (the patient's experience at the visit) relates to improved health outcomes and service use.

Methods

We linked claims-based longitudinal continuity and survey-based self-reported interpersonal continuity indicators for 1,219 Medicare beneficiaries who completed the National Health and Health Services Use Questionnaire. With these linked data, we prospectively evaluated the effect of both types of continuity of care indicators on emergency department use, hospitalization, and mortality over a five-year period.

Results

Patient-reported continuity was associated with reduced emergency department use, preventable hospitalization, and mortality. Most of the claims-based measures, including those most frequently used to assess continuity, were not associated with reduced utilization or mortality.

Conclusion

Our results indicate that the patient- and claims-based indicators of continuity have very different effects on these important health outcomes, suggesting that reform efforts must include the patient-provider experience when evaluating health care quality.

Keywords

OAfund, Medicare, Hospitalizations, Critical care and emergency medicine, Surveys Death rates, Socioeconomic aspects of health, Cardiology, Elderly

Journal Article Version

Version of Record

Published Article/Book Citation

PLoS ONE 9:12 (2014) 18 p., doi:10.1371/journal.pone.0115088

Rights

Copyright © 2014, Suzanne E. Bentler, Robert O. Morgan, Beth A. Virnig, Fredric D. Wolinsky.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.

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URL

https://ir.uiowa.edu/hmp_pubs/1