Association between continuity of care in Swedish primary care and emergency services utilisation : a population-based cross-sectional study
Kohnke, Hannes LU
and Zielinski, Andrzej
LU
(2017)
In Scandinavian Journal of Primary Health Care
35(2).
p.113-119
- Abstract
- Objective: The primary objective of this study was to determine the association between longitudinal continuity of care (CoC) in Swedish primary care (PC) and emergency services (ES) utilisation.
Study design: A cross-sectional analysis of longitudinal population data. Setting. PC centres, out-of-hours PC facilities and emergency departments (EDs) in Blekinge County in southern Sweden. Subjects: People of all ages who lived in Blekinge County and who had made two or more visits per year to a general practitioner (GP) during office hours from 1 January 2012 to 31 December 2014.
Main outcome measure: ES utilisation.
Results: Eight-thousand one-hundred and eighty-five people were included in the study. CoC was... (More) - Objective: The primary objective of this study was to determine the association between longitudinal continuity of care (CoC) in Swedish primary care (PC) and emergency services (ES) utilisation.
Study design: A cross-sectional analysis of longitudinal population data. Setting. PC centres, out-of-hours PC facilities and emergency departments (EDs) in Blekinge County in southern Sweden. Subjects: People of all ages who lived in Blekinge County and who had made two or more visits per year to a general practitioner (GP) during office hours from 1 January 2012 to 31 December 2014.
Main outcome measure: ES utilisation.
Results: Eight-thousand one-hundred and eighty-five people were included in the study. CoC was quantified using three different indices—Usual Provider of Care index (UPC), Continuity of Care index (CoCI), and Sequential Continuity index (SECON). The CoC that the PC centres could offer their enrolled patients varied significantly between the different centres, ranging from 0.23–0.57 for UPC, 0.12–0.43 for CoCI, and 0.25–0.52 for SECON. Association between the three CoC indices and ES utilisation was computed as an incidence rate ratio which ranged between 0.50 and 0.59.
Conclusion: Longitudinal CoC was shown to have a negative association with ES utilisation. The association was significant and of a magnitude that implies clinical relevance. Computed incidence rate ratios suggest that patients with the lowest CoC had twice as many ES visits compared to patients with the highest CoC. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/29bb1d11-c561-43ea-8487-019271004434
- author
- Kohnke, Hannes
LU
and Zielinski, Andrzej
LU
- publishing date
- 2017-06-09
- type
- Contribution to journal
- publication status
- published
- keywords
- Primary health care, Delivery of health care, Health care utilization, Continuity of patient care, Health equity, Health policy, Patient choice, Privatization, Sweden
- in
- Scandinavian Journal of Primary Health Care
- volume
- 35
- issue
- 2
- pages
- 113 - 119
- publisher
- Informa Healthcare
- external identifiers
-
- scopus:85020495724
- ISSN
- 0281-3432
- DOI
- 10.1080/02813432.2017.1333303
- project
- Changes in health care utilization following the Patient Choice Reform of Swedish primary health care: an equity perspective
- language
- English
- LU publication?
- no
- id
- 29bb1d11-c561-43ea-8487-019271004434
- date added to LUP
- 2025-03-06 12:00:12
- date last changed
- 2025-03-08 03:11:16
@article{29bb1d11-c561-43ea-8487-019271004434,
abstract = {{Objective: The primary objective of this study was to determine the association between longitudinal continuity of care (CoC) in Swedish primary care (PC) and emergency services (ES) utilisation.<br/><br/>Study design: A cross-sectional analysis of longitudinal population data. Setting. PC centres, out-of-hours PC facilities and emergency departments (EDs) in Blekinge County in southern Sweden. Subjects: People of all ages who lived in Blekinge County and who had made two or more visits per year to a general practitioner (GP) during office hours from 1 January 2012 to 31 December 2014.<br/><br/>Main outcome measure: ES utilisation.<br/><br/>Results: Eight-thousand one-hundred and eighty-five people were included in the study. CoC was quantified using three different indices—Usual Provider of Care index (UPC), Continuity of Care index (CoCI), and Sequential Continuity index (SECON). The CoC that the PC centres could offer their enrolled patients varied significantly between the different centres, ranging from 0.23–0.57 for UPC, 0.12–0.43 for CoCI, and 0.25–0.52 for SECON. Association between the three CoC indices and ES utilisation was computed as an incidence rate ratio which ranged between 0.50 and 0.59.<br/><br/>Conclusion: Longitudinal CoC was shown to have a negative association with ES utilisation. The association was significant and of a magnitude that implies clinical relevance. Computed incidence rate ratios suggest that patients with the lowest CoC had twice as many ES visits compared to patients with the highest CoC.}},
author = {{Kohnke, Hannes and Zielinski, Andrzej}},
issn = {{0281-3432}},
keywords = {{Primary health care; Delivery of health care; Health care utilization; Continuity of patient care; Health equity; Health policy; Patient choice; Privatization; Sweden}},
language = {{eng}},
month = {{06}},
number = {{2}},
pages = {{113--119}},
publisher = {{Informa Healthcare}},
series = {{Scandinavian Journal of Primary Health Care}},
title = {{Association between continuity of care in Swedish primary care and emergency services utilisation : a population-based cross-sectional study}},
url = {{http://dx.doi.org/10.1080/02813432.2017.1333303}},
doi = {{10.1080/02813432.2017.1333303}},
volume = {{35}},
year = {{2017}},
}