https://scholars.lib.ntu.edu.tw/handle/123456789/493711
標題: | Association of continuity of care with healthcare outcomes and expenses among acute myocardial infarction patients | 作者: | HUI-JU CHIANG YU-CHI TUNG |
公開日期: | 2017 | 卷: | 36 | 期: | 2 | 起(迄)頁: | 161-173 | 來源出版物: | Taiwan Journal of Public Health | 摘要: | Objectives: Previous research has shown that discharged patients following acute myocardial infarction (AMI) who had higher continuity of pre-admission care had better post-discharge care outcomes; however, no study has determined whether or not discharged patients following AMI who had higher continuity of post-discharge care had better post-discharge care outcomes. Moreover, no study has determined the relative strength of influence of pre-admission and postdischarge care continuity on post-discharge outcomes and expenses. Methods: This study utilized data from the nationwide representative sample through the National Health Insurance Research Database, and analyzed 1,884 AMI patients discharged from the hospital between 2007 and 2011. Generalized estimating equation and Cox proportional hazard models with robust sandwich variance estimates were performed to examine the effects of pre-admission and post-discharge care continuity on 1-year post-discharge mortality, readmissions, and medical expenses. Results: There was no significant relationship of continuity of pre-admission care to post-discharge care outcomes and medical expenses. Patients with a high continuity of post-discharge care had lower 1-year post-discharge mortality, readmissions, and medical expenses. Conclusions: Among AMI patients, post-discharge care continuity, rather than pre-admission care continuity, is associated with post-discharge care outcomes and medical expenses. Therefore, to improve postdischarge care outcomes and medical expenses, health policy makers and providers might focus on enhancing continuity of post-discharge care for patients with AMI. |
URI: | http://scholars.lib.ntu.edu.tw/handle/123456789/402019 https://scholars.lib.ntu.edu.tw/handle/123456789/493711 |
ISSN: | 1023-2141 | DOI: | 10.6288/TJPH201736105105 |
顯示於: | 健康政策與管理研究所 |
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