Association between child continuity of care and pediatric avoid hospitalizations
Date Issued
2011
Date
2011
Author(s)
Chang, Wei-Hsin
Abstract
Background: Avoid Hospitalization is a vital indicator of measuring basic healthcare performances for accessibility, quality and efficiency.Several research studies showed that it is affected by the continuity of care.The objectives of this study were to find the suitable pediatric ambulatory care sensitive conditions（ACSCs）in Taiwan, and to discuss the association between child continuity of care indicator and pediatric avoid hospitalization.
Methods: We conducted a survey among 15 pediatric-related professionals,in order to choose the appropriate ACSCs for children in Taiwan.139,867 patients under age 12 were analyzed from Taiwan National Health Insurance Research Database in 2005 according to criteria decided by the survey results.Then we analyzed the data by using logistic regression and negative binominal regression models.
Results: There were 12 pediatric ACSCs selected in agreement with pediatric professionals, including asthma, dehydration, lower respiratory condition and gastroenteritis. By using usual provider of care（UPC）, continuity of care index（COCI）, and sequential continuity（SECON） as the indicators for continuity of care, we inspected the actual situations for child continuity of care in different aspects. The results performed a negative correlation and a dose-response effect relationship between continuity of care and avoid hospitalization, which indicated the higher scores for continuity of care, the lower hospital admission risk.
Conclusions: Although the pediatric ACSCs and the ICD-9-CM Medical Codes in Taiwan differ from those in other countries, a good child continuity of care can effectively reduce hospitalization and avoid hospitalization among children. This study can be the future direction for healthcare quality improvement in both organizational and governmental policy levels.
Subjects
Avoid Hospitalizations
Continuity of care
Primary care
Pediatric Ambulatory Care Sensitive Conditions
Type
thesis
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