The Effect of Continuity of Post-Discharge Care on Heart Failure Outcomes and Expenses
Date Issued
2015
Date
2015
Author(s)
Chiu, Han-Yi
Abstract
Background: Over the past decade, trends in mortality and readmission after discharge have increased among heart failure patients. Thus, patients need to receive consistently outpatient care. Objectives: This study was to examine the associations of continuity of outpatient care with outcomes and expenses for heart failure patients in the 12 months after discharge. Methods: This study used data from the nationwide representative sample through the National Health Insurance Research Database. Heart failure patients who were discharged from hospital be-tween 2007 and 2011 and had outpatient visits with more than three times were selected for analysis. We measured Continuity of Care Index (COCI) by using outpatient data in 12 months after discharge, and COCI scores were divided into three groups: high, medium, low. General-ized estimating equation was performed after adjustment for patient and hospital characteristics to examine the associations of outpatient continuity with 12 months outcomes and total medical expenses of post-discharge care. Results: In this study, a total of 2,927 patients were included. Higher continuity of care after discharge was associated with fewer admissions and lower risk of readmission within 12 months after discharge. High continuity of care was associated with lower risk of 12 months mortality. Higher continuity of care was associated with lower total expenses. Conclusions: Heart failure patients who had higher continuity of care after discharge is associated with fewer admissions, lower risk of readmission, decreased risk of mortality and lower total expenses.
Subjects
heart failure
continuity of care
outcomes of care
medical expenses
Type
thesis
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