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Supplemental Appendixes 1-8
Supplemental Appendixes 1-8
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- Supplemental data: Appendixes 1-8 - PDF file, 12 pages + cover
In Brief
Impact of Continuity of Care on Mortality and Health Care Costs: A Nationwide Cohort Study in Korea
Dong Wook Shin , and colleagues
Background Continuity of care, defined as an ongoing partnership between patient and clinician, is considered a core element of high-quality primary care, but its impact on mortality and health care costs is unclear. This study aims to determine the impact of continuity of care on mortality and health outcomes and costs in patients with newly diagnosed cardiovascular risk factors.
What This Study Found The study found that continuity of care is associated with reduced mortality, morbidity, and health care expenses and may provide added value in the management of chronic conditions. In particular, the study examined a random sample of more than 1,000,000 Korean National Health Insurance enrollees, 47,433 of whom had received new diagnoses of hypertension, diabetes, hypercholesterolemia or other complications. Evaluating the association of three standard indices of continuity of care with patients' overall mortality, cardiovascular mortality, incident cardiovascular events and health care costs over five years, lower indices of continuity of care were associated with higher all-cause and cardiovascular mortality, cardiovascular events and health care costs. Lower continuity of care was associated with increased inpatient and outpatient days and costs.
Implications
- While the findings cannot be generalized to other conditions, the results suggest that continuity of care is a robust predictor of outcomes in patients for conditions with available preventive interventions.
- The authors suggest that, with increasing fragmentation of health care systems and importance of cost containment, health care systems should be designed to support longer-term trusting relationships between patients and physicians, and health policies should encourage patients to concentrate their care with one physician.