Better Continuity of Care Reduces Costs for Diabetic Patients
Resource
AMERICAN JOURNAL OF MANAGED CARE v.17 n.6 pp.420-427
Journal
AMERICAN JOURNAL OF MANAGED CARE
Journal Volume
v.17
Journal Issue
n.6
Pages
420-427
Date Issued
2011
Date
2011
Author(s)
CHEN, CHI-CHEN
CHENG, SHOU-HSIA
Abstract
Objective: To examine the effects of continuity of care on healthcare utilization and expenses for patients with diabetes mellitus. Study Design : Longitudinal study based on claims data. Methods: Data on healthcare utilization and expenses from a 7-year period (2000-2006) were gathered from claims data of the Taiwanese universal health insurance system. The continuity of care index (COCI) was analyzed, and the values were classified into 3 levels. Outcome variables included the likelihood of hospitalization and emergency department visit, pharmaceutical expenses for diabetes-related conditions, and total healthcare expenses for diabetes-related conditions. A generalized estimating equation that considered the effects of repeated measures for the same patients was applied to examine the effects of continuity of care on healthcare utilization and expenses. Results: Compared with patients who had low COCI scores, patients with high or medium COCI scores were less likely to be hospitalized for diabetes-related conditions (odds ratio [OR] 0.26, 95% confidence interval [CI] 0.25, 0.27, and OR 0.58, 95% CI 0.56, 0.59, respectively) or to have diabetes- related emergency department visits (OR 0.34, 95% CI 0.33, 0 .36, and OR 0.64, 95% CI 0.62, 0.66, respectively). Patients with low COCI scores incurred $126 more in pharmaceutical expenses than patients with high COCI scores. Furthermore, patients with high COCI scores had greater savings ($737) in total healthcare expenses for diabetes-related conditions than patients with low COCI scores. Conclusion: Better continuity of care was associated with less healthcare utilization and lower healthcare expenses for diabetic patients. Improving continuity of care might benefit diabetic patients.
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