Unadjusted and Adjusted Incident Rate Ratios for Health Care Utilization (All-Cause and Ambulatory Care-Sensitive Condition-Related Hospitalizations and Emergency Department Visits) and Process of Care Outcomes by Continuity of Primary Care
| Variable | Level of Relational Continuity of Pimary Care | Overall (n = 86,475) | ||||
|---|---|---|---|---|---|---|
| Poor (n = 16,143) | Moderate (n = 25,948) | High (n = 44,384) | ||||
| Health care utilization outcomes | All-cause hospitalizations | Patients, No. | 7,938 | 11,020 | 15,852 | 34,810 |
| All-cause hospitalizations, No. | 19,835 | 25,551 | 32,602 | 77,988 | ||
| Unadjusted incident rate ratio of all-cause hospitalizations (95% CI) | 1.85 (1.79-1.91) | 1.41 (1.37-1.45) | (reference) | |||
| Adjusted incident rate ratio of all-cause hospitalizations (95% CI)a | 1.52 (1.47-1.57) | 1.28 (1.25-1.32) | (reference) | |||
| ACSC-related hospitalizations | Patients, No. | 1,095 | 1,369 | 1,842 | 4,306 | |
| ACSC-related hospitalizations, No. | 1,714 | 2,045 | 2,730 | 6,489 | ||
| Unadjusted incident rate ratio of ACSC-related hospitalizations (95% CI) | 1.96 (1.77-2.16) | 1.35 (1.24-1.48) | (reference) | |||
| Adjusted incident rate ratio of ACSC-related hospitalizations (95% CI)b | 1.58 (1.44-1.74) | 1.23 (1.13-1.34) | (reference) | |||
| All-cause ED visits | Patients, No. | 11,234 | 16,237 | 23,681 | 51,152 | |
| All-cause ED visits, No. | 56,809 | 70,147 | 77,659 | 204,615 | ||
| Unadjusted incident rate ratio of all-cause ED visits (95% CI) | 2.18 (2.12-2.24) | 1.6 (1.56-1.64) | (reference) | |||
| Adjusted incident rate ratio of all-cause ED visits (95% CI)a | 1.78 (1.73-1.83) | 1.42 (1.39-1.46) | (reference) | |||
| ACSC-related ED visits | Patients, No. | 1,414 | 1,731 | 2,272 | 5,417 | |
| ACSC-related ED visits, No. | 2,294 | 2,726 | 3,441 | 8,461 | ||
| Unadjusted incident rate ratio of ACSC-related ED visits (95% CI) | 2.1 (1.92-2.29) | 1.44 (1.33-1.55) | (reference) | |||
| Adjusted incident rate ratio of ACSC-related ED visits (95% CI)b | 1.68 (1.54-1.82) | 1.28 (1.19-1.38) | (reference) | |||
| RAAS inhibitor | Patients, No. | 9,387 | 14,500 | 24,761 | 48,648 | |
| Process of care outcomes | Unadjusted odds ratio (95% CI) | 1.09 (1.05-1.14) | 1.0 (0.97-1.03) | (reference) | ||
| Adjusted odds ratio (95% CI) | 1.03 (0.98-1.07) | 0.99 (0.96-1.02) | (reference) | |||
| Patients, No. | 7,318 | 12,147 | 21,831 | 41,296 | ||
| Statin | Unadjusted odds ratio (95% CI) | 0.75 (0.69-0.8) | 0.86 (0.81-0.92) | (reference) | ||
| Adjusted odds ratio (95% CI) | 0.8 (0.74-0.86) | 0.89 (0.84-0.95) | (reference) | |||
ACSC = ambulatory care-sensitive condition; ED = emergency department; IQR = interquartile range; RAAS = renin-angiotensin-aldosterone system.
↵a Adjusted by age, sex, household location, median household income quintile, cirrhosis, chronic heart failure, peripheral vascular disease, atrial fibrillation, asthma, chronic obstructive pulmonary disease, cancer, diabetes, hypertension, and albuminuria severity.
↵b Adjusted by age, sex, household location, median household income quintile, cirrhosis, peripheral vascular disease, atrial fibrillation, asthma, chronic obstructive pulmonary disease, cancer, diabetes, and albuminuria severity.