Assessment of Continuity of Care and Primary Care Quality in Taiwan: Findings from a National Sample

• Main Authors: Pen-Hua Su, 蘇本華
• Other Authors: 蔡雅芳
• Format: Others
• Language: zh-TW
• Published: 2016
• Online Access: http://ndltd.ncl.edu.tw/handle/qdymjd

碩士 === 中山醫學大學 === 醫療產業科技管理學系碩士班 === 104 === Objectives: This study aims to understand the continuity of care (COC) and to explore the effects of COC on primary care quality in Taiwan’s universal health care system but lacks family physicians and an effective referral mechanism. Methods: This study used a longitudinal health insurance database compiled for 2010 from the National Health Insurance Research Database in Taiwan. COC was calculated using the continuity of care index (COCI), which reflects visit concentration with individual clinicians. Multivariate logistic regression and zero-inflated negative binomial regression were performed to determine the effects of COC on the hospitalizations, hospital admissions, and preventable hospitalizations in 2010, respectively. Results: The average COC score in Taiwan was 0.21 (Min=0, Max=1). The results from the regression models revealed that individuals with higher COC are less likely to have hospitalizations (OR=0.79, 95%CI=0.75-0.82) and have fewer 14.5% (RR=0.855) hospital admissions when compared with individuals with low COC. This study further found that the probability of having preventable hospitalizations was reduced for individuals with high COC (OR= 0.79, 95%CI=0.71-0.88), however, among those hospitalized individuals, the probability of having preventable hospitalizations was increased for individuals with high COC (OR=1.21, 95%CI=1.05-1.39). This study showed that individuals with high COC was significantly associated with hospitalizations, hospital admissions, and preventable hospitalizations. Conclusions: This study showed that COC is associated with decreased hospitalizations, hospital admissions, and preventable hospitalizations, respectively, even in Taiwan’s universal health care system. Improving the COC is beneficial for Taiwan’s health care system.