Continuity and intensity of care among women receiving outpatient care for PTSD.
Continuity of care (COC) is often used as an indicator of treatment quality for patients with severe psychiatric or addictive disorders. However, few studies have examined the relationship between measures of COC and treatment outcomes. This study used standard regression models to examine the strength of the association between continuity of care measures and health outcomes for a sample of female veterans newly entering outpatient treatment for PTSD. There were few consistently significant associations between COC and outcome measures. Four months following program entry only one measure of treatment process, commitment to treatment, was positively associated with one or more continuity of care measures and several COC measures were associated with poor outcomes. Eight months following program entry patients with greater COC during the first four months of treatment had greater declines in violent behavior and PTSD measurements and larger increases in global functioning. However, when a Bonferonni corrected alpha of P < .001 was used to adjust for multiple comparisons, none of the relationships remained statistically significant. Thus, this study provides only weak and inconsistent evidence of the clinical benefits of continuity of care.
Greenberg
Greg A
GA
Northeast Program Evaluation Center, VAMC West Haven, CT 06516, USA. ggreenberg@ssc.wisc.edu
Fontana
Alan
A
Rosenheck
Robert A
RA
D000328:Adult; D000553:Ambulatory Care; D003266:Continuity of Patient Care; D005260:Female; D006801:Humans; D008605:Mental Health Services / Q000706:statistics & numerical data / Q000600:supply & distribution*; D013313:Stress Disorders, Post-Traumatic / Q000628:therapy*; D014481:United States