Claims-based measures of continuity of care have non-linear associations with health: data linkage study.

International Journal of Population Data Science
Bich TranLouisa Jorm

Abstract

Continuity of care (CoC) is considered a central element of good primary care and is often measured using medical claims data. Possible values of CoC depend on the number of claims which is related to health status. This study investigated the relationships between CoC and health status and risk of emergency hospitalisation. Health insurance claims for consultations with general practitioners (GPs) in the 24 months following entry to the 45 and Up Study were used to calculate usual provider continuity (UPC) and the Continuity of Care Index (CoC Index). Relationships of CoC with number of claims, self-rated health and emergency hospitalisation were investigated using descriptive statistics and logistic regression models. Both measures of CoC were strongly related to number of claims and to measures of health status, which were in turn highly associated. Multivariable logistic regression models showed a weak positive relationship between CoC and odds of emergency hospitalisation for those with CoC less than 1, while individuals with perfect CoC had significantly lower odds of hospitalisation compared to all other categories of CoC. However, analyses stratified by, or adjusting for, number of claims showed no clear associations be...Continue Reading

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