Effect of Continuity of Care on Hospital Utilization for Seniors With Multiple Medical Conditions in an Integrated Health Care System

The Article in Brief

Effect of Continuity of Care on Hospital Utilization for Seniors With Multiple Medical Conditions in an Integrated Health Care System

Elizabeth A. Bayliss , and colleagues

Background Continuity of care refers to an ongoing health care relationship. Low continuity of care is associated with more inappropriate medication prescribing, higher cost of care, more avoidable hospitalizations, and greater use of emergency services. This study looks at whether interpersonal continuity (seeing the same clinician over time) is associated with rates of hospital admissions and emergency department use among seniors with multiple chronic medical conditions. The study takes place in an integrated system of health care delivery with high informational continuity (clinical information is available to all clinicians caring for a patient) through shared electronic records.

What This Study Found Greater primary care and specialty care continuity are each associated with lower inpatient admission and lower risk of emergency department visits. For patients with three or more primary care and three or more specialty care visits, specialty care continuity, but not primary care continuity, is associated with a decreased risk of hospital admissions; primary care continuity, but not specialty care continuity, is associated with a decreased risk of emergency department visits.

Implications

• Different subgroups of patients will benefit from continuity with primary and specialty care clinicians depending on their care needs.
• Interpersonal continuity may have a beneficial effect on utilization independent of the informational continuity provided by electronic medical records.