title: Measuring Care Continuity: A Comparison of Claims-based Methods.
abstract: BACKGROUND
  Assessing care continuity is important in evaluating the impact of health care reform and changes to health care delivery. Multiple measures of care continuity have been developed for use with claims data.
  
  
  OBJECTIVE
  This study examined whether alternative continuity measures provide distinct assessments of coordination within predefined episodes of care.
  
  
  METHODS
  This was a retrospective cohort study using 2008-2009 claims files for a national 5% sample of beneficiaries with congestive heart failure, chronic obstructive pulmonary disease, and diabetes mellitus.
  
  
  METHODS
  Correlations among 4 measures of care continuity-the Bice-Boxerman Continuity of Care Index, Herfindahl Index, usual provider of care, and Sequential Continuity of Care Index-were derived at the provider- and practice-levels.
  
  
  RESULTS
  Across the 3 conditions, results on 4 claims-based care coordination measures were highly correlated at the provider-level (Pearson correlation coefficient r=0.87-0.98) and practice-level (r=0.75-0.98). Correlation of the results was also high for the same measures between the provider- and practice-levels (r=0.65-0.92).
  
  
  CONCLUSIONS
  Claims-based care continuity measures are all highly correlated with one another within episodes of care.
authors.affiliation: *Johns Hopkins School of Medicine †Johns Hopkins Bloomberg School of Public Health, Baltimore, MD ‡RAND Corporation, Santa Monica, CA §Division of General Medicine and Primary Care, Brigham and Women's Hospital ∥Harvard Medical School ¶Harvard School of Public Health, Boston, MA.
authors.forename: Craig E
authors.initials: CE
authors.lastname: Pollack
authors.forename: Peter S
authors.initials: PS
authors.lastname: Hussey
authors.forename: Robert S
authors.initials: RS
authors.lastname: Rudin
authors.forename: D Steven
authors.initials: DS
authors.lastname: Fox
authors.forename: Julie
authors.initials: J
authors.lastname: Lai
authors.forename: Eric C
authors.initials: EC
authors.lastname: Schneider
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003920:Diabetes Mellitus / Q000628:therapy*; D005260:Female; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D007345:Insurance Claim Review / Q000706:statistics & numerical data*; D008297:Male; D010346:Patient Care Management / Q000458:organization & administration* / Q000592:standards; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy*; D012189:Retrospective Studies