The association of longitudinal and interpersonal continuity of care with emergency department use, hospitalization, and mortality among medicare beneficiaries

Suzanne E. Bentler, Robert O. Morgan, Beth A. Virnig, Fredric D. Wolinsky, Tina Hernandez-Boussard

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

Abstract

Background: Continuity of medical care is widely believed to lead to better health outcomes and service utilization patterns for patients. Most continuity studies, however, have only used administrative claims to assess longitudinal continuity with a provider. As a result, little is known about how interpersonal continuity (the patient's experience at the visit) relates to improved health outcomes and service use.

Methods: We linked claims-based longitudinal continuity and survey-based selfreported interpersonal continuity indicators for 1,219 Medicare beneficiaries who completed the National Health and Health Services Use Questionnaire. With these linked data, we prospectively evaluated the effect of both types of continuity of care indicators on emergency department use, hospitalization, and mortality over a fiveyear period.

Results: Patient-reported continuity was associated with reduced emergency department use, preventable hospitalization, and mortality. Most of the claimsbased measures, including those most frequently used to assess continuity, were not associated with reduced utilization or mortality.

Conclusion: Our results indicate that the patient- and claims-based indicators of continuity have very different effects on these important health outcomes, suggesting that reform efforts must include the patient-provider experience when evaluating health care quality.

Original languageEnglish (US)
Article numbere115088
JournalPloS one
Volume9
Issue number12
DOIs
StatePublished - Dec 22 2014

Fingerprint Dive into the research topics of 'The association of longitudinal and interpersonal continuity of care with emergency department use, hospitalization, and mortality among medicare beneficiaries'. Together they form a unique fingerprint.

Cite this