Continuity of care is good for elderly people with diabetes: retrospective cohort study of mortality and hospitalization.
OBJECTIVE
To examine the relationship between continuity of family physician care and all-cause mortality and acute hospitalizations in older people with diabetes.


METHODS
Retrospective cohort study of administrative health databases. Continuity of family physician care for elderly patients newly diagnosed with diabetes was estimated by 3 continuity indexes using physician claims data. The relationship of continuity of family physician care to mortality and acute hospitalizations was investigated.


METHODS
The province of Newfoundland and Labrador.


METHODS
A total of 305 family practice patients 65 years of age or older with diabetes.


METHODS
Death rate and hospitalization rate during a 3-year period.


RESULTS
Overall, continuity of family physician care was high. In the 3 years examined, the higher-continuity group had lower rates of hospitalization (53.5% vs 68.2%) and death (8.6% vs 18.5%) than the lower-continuity group.


CONCLUSIONS
The findings suggest an association between higher continuity of family physician care and reductions in likelihood of death and hospitalizations in older people with diabetes.
Department of Family Medicine, Memorial University of Newfoundland, St John’s. gworrall@mun.ca
Graham
G
Worrall
John
J
Knight
D000368:Aged; D000369:Aged, 80 and over; D003266:Continuity of Patient Care / Q000592:standards* / Q000706:statistics & numerical data; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000401:mortality* / Q000628:therapy; D005260:Female; D006299:Health Services for the Aged / Q000191:economics / Q000592:standards*; D006760:Hospitalization / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D008297:Male; D009523:Newfoundland and Labrador / Q000453:epidemiology; D009819:Office Visits / Q000706:statistics & numerical data / Q000639:trends; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D010821:Physicians, Family / Q000706:statistics & numerical data*; D015995:Prevalence; D012189:Retrospective Studies; D018571:Sentinel Surveillance; D017678:Sex Distribution
Aust Fam Physician. 1998 Jan;27 Suppl 1:S44-6
9503736
Ann Fam Med. 2004 Sep-Oct;2(5):445-51
15506579
Br J Gen Pract. 2001 Sep;51(470):712-8
11593831
Br J Gen Pract. 1995 Mar;45(392):133-5
7772390
Can Fam Physician. 1997 Nov;43:1902-4, 1909-12
9386873
J Fam Pract. 1998 Oct;47(4):290-7
9789515
Arch Fam Med. 1998 Jul-Aug;7(4):352-7
9682689
Am J Manag Care. 1999 Jun;5(6):727-34
10538452
Am J Public Health. 1996 Dec;86(12):1742-7
9003131
Ann Fam Med. 2003 Sep-Oct;1(3):162-70
15043378
Med Care. 1999 Jun;37(6):547-55
10386567
J Fam Pract. 1975 Oct;2(5):371-2
1206365
Pediatrics. 1985 Oct;76(4):495-507
3931044
Ann Fam Med. 2005 Mar-Apr;3(2):159-66
15798043
Pediatrics. 1976 Jun;57(6):917-30
934747
Med Care. 2002 Feb;40(2):137-44
11802086
Health Serv Res. 2005 Apr;40(2):389-400
15762898
Am J Public Health. 1980 Feb;70(2):122-7
7352605
Med Care. 1979 Jun;17(6):551-65
449431