Risk of Death and Cardiovascular Endpoints by Level of Continuity of Care (N = 47,433)
| Most Frequent Provider Continuity | Modified, Modified Continuity Index | Continuity of Care Index | ||||
|---|---|---|---|---|---|---|
| Endpoint | Above Median | Below Median | Above Median | Below Median | Above Median | Below Median |
| All cause mortality | ||||||
| No. of deaths (deaths per 1,000 py) | 1,340 (11.5) | 1,787 (15.4) | 1,296 (11.3) | 1,831 (15.5) | 1,345 (11.6) | 1,782 (15.4) |
| Crude HR (95% CI) | 1.00 (Ref) | 1.33 (1.24–1.43) | 1.00 (Ref) | 1.37 (1.28–1.47) | 1.00 (Ref) | 1.33 (1.24–1.43) |
| Multivariable-adjusted HRa (95% CI) | 1.00 (Ref) | 1.13 (1.05–1.21) | 1.00 (Ref) | 1.13 (1.05–1.21) | 1.00 (Ref) | 1.12 (1.04–1.21) |
| Cardiovascular mortality | ||||||
| No. of deaths (deaths per 1,000 py) | 321 (2.8) | 494 (4.3) | 299 (2.6) | 516 (4.4) | 321 (2.8) | 494 (4.3) |
| Crude HR (95% CI) | 1.00 (Ref) | 1.54 (1.34–1.77) | 1.00 (Ref) | 1.67 (1.45–1.93) | 1.00 (Ref) | 1.54 (1.34–1.77) |
| Multivariable-adjusted HRa (95% CI) | 1.00 (Ref) | 1.30 (1.12–1.50) | 1.00 (Ref) | 1.40 (1.21–1.62) | 1.00 (Ref) | 1.30 (1.13–1.50) |
| Noncardiovascular mortality | ||||||
| No. of deaths (deaths per 1,000 py) | 1,019 (8.8) | 1,293 (11.1) | 997 (8.7) | 1,315 (11.2) | 1,024 (8.8) | 1,288 (11.1) |
| Crude HR (95% CI) | 1.00 (Ref) | 1.27 (1.17–1.38) | 1.00 (Ref) | 1.28 (1.18–1.39) | 1.00 (Ref) | 1.26 (1.16–1.37) |
| Multivariable-adjusted HRa (95% CI) | 1.00 (Ref) | 1.07 (0.99–1.17) | 1.00 (Ref) | 1.05 (0.96–1.14) | 1.00 (Ref) | 1.07 (0.98–1.16) |
| Myocardial infarctiona | ||||||
| No. of incident events (incident events per 1,000 py) | 144 (1.2) | 232 (2.0) | 147 (1.3) | 229 (1.9) | 144 (1.2) | 232 (2.0) |
| Crude HR (95% CI) | 1.00 (Ref) | 1.61 (1.31–1.98) | 1.00 (Ref) | 1.51 (1.23–1.86) | 1.00 (Ref) | 1.62 (1.31–1.99) |
| Multivariable-adjusted HRa (95% CI) | 1.00 (Ref) | 1.57 (1.27–1.94) | 1.00 (Ref) | 1.51 (1.22–1.87) | 1.00 (Ref) | 1.57 (1.28–1.95) |
| Cerebral infarctionb | ||||||
| No. of incident events (incident events per 1,000 py) | 427 (3.8) | 668 (6.0) | 422 (3.8) | 673 (6.0) | 427 (3.8) | 668 (6.0) |
| Crude HR (95% CI) | 1.00 (Ref) | 1.59 (1.41–1.80) | 1.00 (Ref) | 1.58 (1.40–1.78) | 1.00 (Ref) | 1.60 (1.41–1.80) |
| Multivariable-adjusted HRa (95% CI) | 1.00 (Ref) | 1.43 (1.27–1.62) | 1.00 (Ref) | 1.43 (1.26–1.63) | 1.00 (Ref) | 1.44 (1.27–1.63) |
| Cerebral hemorrhageb | ||||||
| No. of incident events (incident events per 1,000 py) | 141 (1.2) | 184 (1.6) | 136 (1.2) | 189 (1.6) | 141 (1.2) | 184 (1.6) |
| Crude HR (95% CI) | 1.00 (Ref) | 1.30 (1.05–1.62) | 1.00 (Ref) | 1.35 (1.08–1.68) | 1.00 (Ref) | 1.31 (1.05–1.63) |
| Multivariable-adjusted HRa (95% CI) | 1.00 (Ref) | 1.19 (0.95–1.49) | 1.00 (Ref) | 1.20 (0.96–1.52) | 1.00 (Ref) | 1.19 (0.95–1.49) |
CI = confidence interval; HR = hazard ratio; py = person-year; Ref = reference value.
↵a Multivariable adjustments included age, sex, income, Charlson comorbidity index, number of visits during the first 2 years, and residential area (for detail, see text).
↵b Excluding those who developed the indicated outcome during the first 2 years after diagnosis.