Table 1
The formulas of four continuity of care measures.
| CONTINUITY MEASURES | FORMULAS |
|---|---|
| COC | |
| HI | |
| UPC | |
| SECON |
[i] p = total number of providers; n = total number of visits during the episode; ni = number of visits to provider i; cj = indicator of sequential visits to same providers, equal to 1 if visits j and j+1 are to the same provider, 0 otherwise.
COC indicates Bice-Boxerman Continuity of Care Index; HI, Herfindahl Index; SECON, Sequential Continuity Index; UPC, Usual Provider of Care.
Table 2
The detailed characteristics of 1406 patients in Yuhuan City between September 2017 and August 2019.
| VARIABLES (n = 1406) | N (%) |
|---|---|
| Age, mean (SD) | 65.57 (11.93) |
| Sex | |
| Female | 752 (53.49) |
| Male | 654 (46.51) |
| Medical insurance program | |
| Urban Employee Basic Medical Insurance | 140 (9.96) |
| Resident Basic Medical Insurance | 1266 (90.04) |
| Chronic diseases | |
| Hypertension | 972 (69.13) |
| Diabetes | 116 (8.25) |
| Both hypertension and diabetes | 318 (22.62) |
| Number of outpatient encounters, mean (SD) | 36.19 (32.88) |
| Village/community | |
| Village/community 1 | 140 (9.96) |
| Village/community 2 | 162 (11.52) |
| Village/community 3 | 265 (18.85) |
| Village/community 4 | 217 (15.43) |
| Village/community 5 | 85 (6.05) |
| Village/community 6 | 214 (15.22) |
| Village/community 7 | 137 (9.74) |
| Village/community 8 | 186 (13.23) |
| Total outpatient costs, mean (SD) | 2567 (5351) |
| Reimbursed | 1340 (4238) |
| Out-of-pocket | 1226 (1448) |
| Any inpatient costs, n (%) | 445 (31.65) |
| Total unconditional inpatient costs, mean (SD) | 3495 (10461) |
| Reimbursed | 1771 (6457) |
| Out-of-pocket | 1723 (5065) |
| Total conditional inpatient costs, mean (SD) | 11042 (16211) |
| Reimbursed | 5635 (10537) |
| Out-of-pocket | 5445 (7802) |
| Predictors of interest, mean (SD) | |
| COC | 0.58 (0.24) |
| HI | 0.61 (0.22) |
| UPC | 0.71 (0.19) |
| SECON | 0.68 (0.21) |
| Having a primary care provider as UPC, n (%) | 605 (43.03) |
[i] COC indicates Bice-Boxerman Continuity of Care Index; HI, Herfindahl Index; SD, standard deviation; SECON, Sequential Continuity Index; UPC, Usual Provider of Care.
Table 3
The association between continuity of care and outpatient costs between September 2017 and August 2019.
| PRIMARY PREDICTORS, COEF (95% CI) | COC | HI | UPC | SECON | PCP-UPC |
|---|---|---|---|---|---|
| Total costs | –151*** (–208, –94) | –178*** (–240, –116) | –228*** (–298, –158) | –194*** (–259, –130) | –321* (–627, –15) |
| Reimbursed costs | –42* (–82, –2) | –52 * (–95, –9) | –74** (–123, –25) | –80** (–125, –35) | –22 (–233, 190) |
| Out-of-pocket costs | –109*** (–132, –86) | –126*** (–151, –101) | –154*** (–182, –126) | –115*** (–141, –88) | –299*** (–424, –174) |
[i] *p < 0.05, **p < 0.01, ***p < 0.001.
Ordinary least squares models adjusted for age, sex, village, medical insurance program, chronic diseases, number of total outpatient visits, and number of total outpatient visits squared.
CI indicates confidence interval; COC, Bice-Boxerman Continuity of Care Index; coef, coefficient; HI, Herfindahl Index; PCP-UPC, Having a primary care provider as the usual provider of care; SECON, Sequential Continuity Index; UPC, Usual Provider of Care.
Figure 1
Saved outpatient costs when setting continuity of care to 1 compared to status quo.
COC indicates Bice-Boxerman Continuity of Care Index; HI, Herfindahl Index; PCP-UPC, Having a primary care provider as the usual provider of care; SECON, Sequential Continuity Index; UPC, Usual Provider of Care.
Table 4
The association between continuity of care and inpatient costs between September 2017 and August 2019.
| PRIMARY PREDICTORS, COEF (95% CI) | COC | HI | UPC | SECON | PCP-UPC |
|---|---|---|---|---|---|
| Any cost, OR (95% CI) | 0.77*** (0.72, 0.82) | 0.74*** (0.69, 0.79) | 0.74*** (0.69, 0.80) | 0.79*** (0.74, 0.85) | 0.32*** (0.24, 0.44) |
| Total conditional costs (n = 445) | –773 (–1563, 18) | –824 (–1657, 9) | –830 (–1714, 53) | –889* (–1758, –21) | –4887* (–9146, –628) |
| Reimbursed conditional costs (n = 442) | –168 (–676, 341) | –187 (–722, 349) | –168 (–735, 399) | –277 (–834, 280) | –2286 (–5026, 454) |
| Out-of-pocket conditional costs (n = 445) | –589** (–971, –206) | –620** (–1023, –217) | –648** (–1076, –221) | –598** (–1019, –177) | –2515* (–4587, –443) |
[i] *p < 0.05, **p < 0.01, ***p < 0.001.
Ordinary least squares models adjusted for age, sex, village, medical insurance program, chronic diseases, number of total outpatient visits, and number of total outpatient visits squared.
CI indicates confidence interval; COC, Bice-Boxerman Continuity of Care Index; coef, coefficient; HI, Herfindahl Index; OR, odds ratio; PCP-UPC, Having a primary care provider as the usual provider of care; SECON, Sequential Continuity Index; UPC, Usual Provider of Care.
Figure 2
Saved unconditional inpatient costs when setting continuity of care to 1 compared to status quo.
COC indicates Bice-Boxerman Continuity of Care Index; HI, Herfindahl Index; PCP-UPC, Having a primary care provider as the usual provider of care; SECON, Sequential Continuity Index; UPC, Usual Provider of Care.