The effect of continuity of care on potentially avoidable hospitalizations and healthcare costs in older adults with dementia

• Main Authors: Wen-YenHuang, 黃文嬿
• Other Authors: Li-Jung Ku
• Format: Others
• Language: zh-TW
• Published: 2018
• Online Access: http://ndltd.ncl.edu.tw/handle/6rrb6d

碩士 === 國立成功大學 === 公共衛生研究所 === 106 === The purpose of this study is to examine the associations between continuity of care (COC) and healthcare outcomes, including all-cause hospitalization, potentially avoidable hospitalizations (PAHs) and medical expenditures on individual with dementia. The subjects of this study were elders with dementia (aged 65 and older) in 2011 from National Health Insurance Research Database (NHIRD), and patients were divided into high COCI group and low COCI group by their continuity of care index (COCI) in 2011. PAHs were classified into five types: (1) serious short-term complications of diabetes; (2) serious long-term complications of diabetes; (3) COPD or asthma; (4) hypertension; (5) heart failure according to MACIE (Medicare Ambulatory Care Indicators For The Elderly) in the US. Medical expenditures were classified into three types, including outpatient, inpatient, and total expenditures. Logistic regression models were used to identify the effect of COCI in dementia on all-cause hospitalization and PAHs in the subsequent year. Generalized linear models were developed to identify the effect of COCI in dementia on outpatient, inpatient, and total expenditures in the subsequent year. The findings showed that high COCI in dementia was significantly associated with lower likelihood of all-cause hospitalization and lower medical expenditures than low COCI, but there was no significant effect on PAHs.