Interpersonal continuity of care and type two diabetes

Lustman, Alex; Comaneshter, Doron; Vinker, Shlomo

doi:10.1016/j.pcd.2015.10.001

Cited by 41 publications

(54 citation statements)

References 16 publications

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“…[21][22][23] However, relatively little is known about the effects of a specific aspect of continuity of care, primary care physician turnover.24 Physician turnover, which involves a physician's leaving clinical practice in a specific area, may disrupt continuity of care by diminishing opportunities for establishing trusting physicianpatient relationships and reducing the quality of communication and information needed for care. [25][26][27] Patients forced to change their family physician report low satisfaction with care and loss of trust, 28 whereas higher physician retention has been shown to be associated with better patient satisfaction and preventive care outcomes [25][26][27]29 and may be associated with reduced use of health care services.…”

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confidence: 99%

“…[21][22][23] However, relatively little is known about the effects of a specific aspect of continuity of care, primary care physician turnover.…”

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confidence: 99%

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confidence: 99%

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Relation between family physician retention and avoidable hospital admission in Newfoundland and Labrador: a population-based cross-sectional study

2017

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R elational continuity of care with a primary care physician has been associated with improved problem recognition, 1 preventive care, 2-4 patient satisfaction and treatment adherence [5][6][7][8][9] as well as reduced use of health care services, 10-17 health care costs 18-20 and mortality. [21][22][23] However, relatively little is known about the effects of a specific aspect of continuity of care, primary care physician turnover.24 Physician turnover, which involves a physician's leaving clinical practice in a specific area, may disrupt continuity of care by diminishing opportunities for establishing trusting physicianpatient relationships and reducing the quality of communication and information needed for care. [25][26][27] Patients forced to change their family physician report low satisfaction with care and loss of trust, 28 whereas higher physician retention has been shown to be associated with better patient satisfaction and preventive care outcomes [25][26][27]29 and may be associated with reduced use of health care services.Although several studies have shown that higher continuity with a primary care physician is associated with reduced preventable hospital admissions for ambulatory-care-sensitive conditions, 13,14,17,30 we were unable to find any studies examining the relation between physician turnover/retention and hospital admission. Studying the effects of retention is important because changes to health policy required to address this issue are different from those for continuity. In addition, measuring physician turnover or retention may offer a proxy measure for continuity of care when it is not possible to measure continuity at the individual level.Newfoundland and Labrador has a long history of physician shortages, exacerbated by the out-migration of physicians. Background: Physician turnover, involving physicians' leaving clinical practice in a specific area, may disrupt continuity of care, leading to poorer health outcomes and greater use of health care services. The purpose of this study was to investigate the relation between family physician retention and avoidable hospital admission for ambulatory-care-sensitive conditions. Relation between family physician retention and avoidable hospital admission in Newfoundland and

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confidence: 99%

“…[21][22][23] However, relatively little is known about the effects of a specific aspect of continuity of care, primary care physician turnover.…”

mentioning

confidence: 99%

mentioning

confidence: 99%

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Relation between family physician retention and avoidable hospital admission in Newfoundland and Labrador: a population-based cross-sectional study

2017

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“…We took the indices being used to measure the continuity of care by reflecting the density, dispersion and sequence in order to depict the patients' move through the healthcare system. These indices for the dependent variables are UPC (Usual Provider Continuity Ratio), COC (Continuity of Care Index) and SECON (Sequential Continuity Index) [13][14][15][16][17][18].…”

Section: Variablesmentioning

confidence: 99%

Which Medical Institution Should Perform Gatekeeping in Rural China? Results from a Cross-Sectional Study

Niehoff²,

Zhang

et al. 2016

Gesundheitswesen

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China's healthcare system is developing very fast but needs a regulatory practice, which helps to improve effectiveness and efficiency. This is a problem in rural China, in particular. The government is promoting a providing system with gatekeeping and mandatory referral procedures in order to limit resulting problems. However, there exists little evidence, which of the primary healthcare facilities in rural China should be given these functions. It is this study's objective to determine the impact of the specific medical institution of an initial visit on the patients' following move through the healthcare system. On that reason, we want to find evidence which level of primary health sectors in rural China is more appropriate to perform gatekeeping and to integrate care based on referrals. The alternatives are either to prefer village clinics or township health centers. The data were collected through a cross-sectional study in 2012, which used a stratified random sampling method to select 4 counties. 420 patients who wanted to see the doctors more than 3 times during the past 6 months were included as the study sample. We described the patients' move through the healthcare system by measuring the density, dispersion and sequence of visits according to the Continuity of Care model (COC). The logistic regression model was used to determine the influence of medical institution of initial visit on patients' moves after controlling other variables. We found that patients who chose the county hospital as medical institution for their initial visit had 5.88 times of the odds of high (vs. low) density, 4.17 times the odds of high (vs. low) dispersion, and 2.86 times the odds of high (vs. low) sequence of visits than those choosing village clinics as medical institution for the initial visit. However, patients choosing the county hospitals as medical institution of initial visit did not report higher density, dispersion or sequence of visit than the patients who chose the township health centers. For the overwhelming majority of rural areas in China, the township health centers are more appropriate to perform the gatekeeping role than village clinics are. We see that as the conclusion at least at the present stage of the system's development.

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“…As continuity of care received increasing attention 78 , numerous studies attempted to evaluate the factors of continuity to apply to primary healthcare environment. Factors associated with the level of continuity were categorized into population demographic, patient factors, quality of care 9 , and interpersonal relationships -between patient and physician 5 . Yet many of the factors mentioned were determined based on surveys and interviews, making it susceptible to bias.…”

Section: Introductionmentioning

confidence: 99%

Analysis of Continuity of Care and Related Factors in Diabetes Patients in Korea

Shin

Kim

Cho

et al. 2020

Preprint

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Background: Diabetes is one of the fastest growing diseases with approximately 463 million patients worldwide. It is established that to manage diabetes, continuity of care in primary care setting is crucial. We aim to statistically define and analyze factors of continuity that are associated with patient, clinic and geographical relationship.Methods: We used 2014~2015 claim data from National Health Insurance Service (NHIS), with 39,096 eligible outpatient attendances across 29,912 office-based clinics. We applied multivariable logistic regression to analyze factors that may affect three kinds of continuity of care index for each patient: most frequent provider continuity index (MFPC), modified-modified continuity index (MMCI), and continuity of care index (COC). Results: Mean value of continuity of care indices were MFPC 0.90, MMCI 0.96, COC 0.85. Among patient factors, old age above 80 (MFPC 0.81 [0.74-0.89], MMCI 0.84 [0.76-0.92], COC 0.81 [0.74-0.89]) and disability were strongly associated with lower continuity of care. Another significant factor was residential area: further the patients lived from their primary care clinic, lower the continuity of diabetes care (MFPC 0.74 [0.70–0.78], MMCI 0.70 [0.66–0.73], COC 0.74 [0.70–0.78]). Patients who lived in metropolitan area had higher continuity of care compared to other areas (metropolitan area, MFPC 1.19 [1.17-1.27], MMCI 1.17 [1.10-1.25], COC 1.19 [1.12-1.27]). There was no statistical significance among clinic factors, such as number of hired physicians or nurses hired per clinic, between the lower and the higher continuity of care groups.Conclusion: Geographical proximity of patient’s residential area and clinic location showed highest correlation as factor of continuity. Political support is necessary to geographically align the imbalance of supply and demand of medical needs.

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Interpersonal continuity of care and type two diabetes

Cited by 41 publications

References 16 publications

Relation between family physician retention and avoidable hospital admission in Newfoundland and Labrador: a population-based cross-sectional study

Relation between family physician retention and avoidable hospital admission in Newfoundland and Labrador: a population-based cross-sectional study

Which Medical Institution Should Perform Gatekeeping in Rural China? Results from a Cross-Sectional Study

Analysis of Continuity of Care and Related Factors in Diabetes Patients in Korea

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