The association between continuity of care and inappropriate medication among geriatric population
Date Issued
2011
Date
2011
Author(s)
Chu, Hsuan-Yin
Abstract
Background
The Taiwan Department of Household Registration Affairs reported aging ( > 65 year-old) population significantly increased during the past decade. Key characteristics of this population are having multiple medical conditions. They consume significant proportion of medical resources in Taiwan which is around 30% of total national health insurance expenditure. Under this atmosphere, the risk of potential inappropriate medication utilization can be increased when shifting the physicians or the health care resources overuse under this open access system.
Objective
This primary objective of this study is to understand the relationship between continuity of care and potential inappropriate medication utilization under this national health insurance system.
Method
This database contains all of the original claim data of one million beneficiaries, who are randomly enrolled from the total registry beneficiaries in year 2005. We choose two indices to measure the continuity of care among elderly patient included in this study. First, this study applied usual provider of care (UPC) index and the second is Continuity of Care Index(COCI).
Result
The results revealed that patients with high COCI score were less likely to receive a potential inappropriate medications (odd rations [OR] 0.55, 95% confidence interval [CI] 0.53-0.57) or duplicated medication (OR=0.33, 95% CI 0.31-0.35) compared with patients in the low COC group. The similar findings can be noted when we adapted UPC as the indicator of continuity of care. Patients with high UPC score were less likely to receive a potential inappropriate medications (odd rations [OR] 0.51, 95% confidence interval [CI] 0.48-0.53) or duplicated medication (OR=0.29, 95% CI 0.28-0.30) compared with patients in the low UPC group.
Conclusion
Better continuity of care among this geriatrics population can improve the utilization of potential inappropriate medication and duplicated medications. Improvement of continuity of care is crucial to avoid relevant complications due to medication not be used properly.
Subjects
continuity of care
geriatric population
potential inappropriate medication
medication duplication
Type
thesis
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