Continuity of care and avoidable hospitalizations for Chronic Obstructive Pulmonary Disease (COPD)

Background: numerous studied suggest that better continuity of care could result in better health outcomes. however,few studies have examined the relationship between continuity of care and avoidable hospitalizations. methods: a retrospective cohort study design was adopted. we used secondary data analysis based on claim data regarding health care utilization under a universal coverage health insurance scheme in taiwan. the study population included 3,015 subjects who were newly diagnosed with chronic obstructive pulmonary disease (copd) in 2006. the main outcome was copd-related avoidable hospitalization,and the continuity of care index (coci) was used to measure continuity of care. a logistic regression model was used to control for sex,age,low-income status,and health status. results: with regard to the effects of continuity of care on avoidable hospitalizations,dose-response trends were observed. the logistic regression model showed that after controlling for covariables,subjects in the low coci group were 129% (adjusted odds ratio,2.29; 95% confidence interval,1.26-4.15) more likely to undergo copd-related avoidable hospitalizations than those in the high coci group. conclusions: patients with copd with higher continuity of care had a significantly lower likelihood of avoidable hospitalization. to prevent future hospitalizations,health policy stakeholders should encourage physicians and patients to develop long-term relationships to further improve their health outcomes. © 2015,american board of family medicine. all rights reserved.