Does continuity of care matter in a health care system that lacks referral arrangements?

作者：Cheng Shou Hsia^*; Hou Yen Fei; Chen Chi Chen

来源：Health Policy and Planning, 2011, 26(2): 157-162.

DOI：10.1093/heapol/czq035

• Continuity of care
• physician visit
• hospital admission
• emergency department visit
• Taiwan

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.

• 出版日期2011-3