Blozik Eva, Bähler Caroline, Näpflin Markus, Scherer Martin
Department of Health Sciences, Helsana Group, Zürich, Switzerland.
Institute of Primary Care, University of Zürich, Zürich, Switzerland.
Patient Prefer Adherence. 2020 Nov 18;14:2253-2262. doi: 10.2147/PPA.S266381. eCollection 2020.
Continuity of care is positively associated with beneficial patient outcomes. Data on the level of continuity of care in the ambulatory setting in Switzerland are lacking.
The aim of this study was to evaluate continuity of care in Swiss cancer patients based on routine data of mandatory health insurance using four established continuity scales.
Retrospective analysis of Swiss claims data (N=23'515 patients with incident use of antineoplastics). The Usual Provider Continuity score, the Modified Modified Continuity Index, the Continuity of Care index, and the Sequential Continuity Index were analyzed based on consultations with general practitioners (GPs), physician specialists and ambulatory hospital wards.
Using information of health insurance claims, the number of consultations and the general level of continuity of care in Swiss cancer patients are high. Continuity of care scores were significantly associated with sociodemographic and regional factors. When focusing on consultations with GPs only, all four scores consistently showed high values indicating high levels of continuity. Continuity with general practitioners was associated with lower costs and lower risks for hospitalization and death.
This is the first study giving insight into continuity of care in Swiss cancer patients. The present study shows that continuity of care is measurable using health insurance claims data. It indicates that continuity with general practitioners is associated with a beneficial outcome.
医疗连续性与患者的良好预后呈正相关。瑞士门诊环境下的医疗连续性水平数据尚缺。
本研究旨在基于强制性医疗保险的常规数据,使用四种既定的连续性量表评估瑞士癌症患者的医疗连续性。
对瑞士索赔数据进行回顾性分析(N = 23515例初次使用抗肿瘤药物的患者)。基于与全科医生(GP)、专科医生和门诊医院病房的会诊情况,分析了通常医疗服务提供者连续性评分、改良的改良连续性指数、医疗连续性指数和序贯连续性指数。
利用医疗保险索赔信息,瑞士癌症患者的会诊次数和医疗连续性总体水平较高。医疗连续性评分与社会人口统计学和地区因素显著相关。仅关注与全科医生的会诊时,所有四个评分均始终显示出较高的值,表明连续性水平较高。与全科医生的连续性与较低的成本以及较低的住院和死亡风险相关。
这是第一项深入了解瑞士癌症患者医疗连续性的研究。本研究表明,利用医疗保险索赔数据可衡量医疗连续性。这表明与全科医生的连续性与良好结局相关。