Kaohsiung Veterans General Hospital.
Meiho University; Kaohsiung Medical University; Kaohsiung Veterans General Hospital.
Health Informatics J. 2020 Mar;26(1):318-327. doi: 10.1177/1460458218824720. Epub 2019 Jan 31.
This study investigated the association between care continuity and chronic conditions in relation to highly frequent use of outpatient service in order to find constructive suggestions to bring efficient, high-quality care for patients with multiple chronic conditions. The National Health Insurance database was used and 333,294 patients were identified from 2007 to 2009. The continuity of care index indicates the dispersion of a patient's ambulatory visits among providers. Multivariate logistic regression was used to estimate adjusted odds ratios with 95 percent confidence intervals. Continuity of care index was significantly associated with age, sex, urbanization level, socioeconomic status, emergency department visits, hospitalization, psychological disorders, chronic diseases, and catastrophic illness card; those with low continuity of care index were likely to use outpatient care highly frequently. Improving continuity of care is fundamental, and the best way is to advance the practice of family medicine for primary care.
本研究旨在探讨连续性护理与慢性病之间的关系,以及其与高频率门诊服务使用之间的关系,以便为患有多种慢性病的患者提供高效、高质量的护理提出建设性建议。本研究使用了国家健康保险数据库,从 2007 年至 2009 年确定了 333294 名患者。连续性护理指数用于表示患者在就诊提供者之间的门诊就诊分散程度。采用多变量逻辑回归估计调整后的优势比及其 95%置信区间。连续性护理指数与年龄、性别、城市化水平、社会经济地位、急诊科就诊、住院、心理障碍、慢性病和灾难性疾病卡显著相关;连续性护理指数较低的患者更有可能高频使用门诊护理。提高连续性护理质量至关重要,最好的方法是推进家庭医学在初级保健中的应用。