Impact of family practice continuity of care on unplanned hospital use for people with serious mental illness

被引：27

作者：

Ride, Jemimah ^{[1
]}

Kasteridis, Panagiotis ^{[2
]}

Gutacker, Nils ^{[2
]}

Doran, Tim ^{[3
]}

Rice, Nigel ^{[2
]}

Gravelle, Hugh ^{[2
]}

Kendrick, Tony ^{[4
]}

Mason, Anne ^{[2
]}

Goddard, Maria ^{[2
]}

Siddiqi, Najma ^{[3
,5
,6
]}

Gilbody, Simon ^{[7
]}

Williams, Rachael ^{[8
]}

Aylott, Lauren ^{[9
]}

Dare, Ceri ^{[10
]}

Jacobs, Rowena ^{[2
]}

机构：

[1] Univ Melbourne, Melbourne Sch Populat & Global Hlth, Ctr Hlth Policy, Hlth Econ Unit, Level 4,207 Bouverie St, Parkville, Vic 3010, Australia

[2] Univ York, Ctr Hlth Econ, York, N Yorkshire, England

[3] Univ York, Dept Hlth Sci, York, N Yorkshire, England

[4] Univ Southampton, Dept Primary Care, Southampton, Hants, England

[5] Hull York Med Sch, York, N Yorkshire, England

[6] Bradford Dist Care NHS Fdn Trust, Bradford, W Yorkshire, England

[7] Univ York, Mental Hlth & Addict Res Grp, Dept Hlth Sci, York, N Yorkshire, England

[8] Clin Practice Res Datalink, London, England

[9] Hull York Med Sch, Hlth Profess Educ Unit, York, N Yorkshire, England

[10] Serv User, York, N Yorkshire, England

来源：

HEALTH SERVICES RESEARCH | 2019年 / 54卷 / 06期

基金：

芬兰科学院; 美国国家卫生研究院;

关键词：

continuity of care; family practice; hospital care; serious mental illness; HEALTH-CARE; AVOIDABLE HOSPITALIZATION; GENERAL-PRACTITIONERS; BIPOLAR DISORDER; MORTALITY GAP; UNITED-STATES; SCHIZOPHRENIA; PHYSICIAN; COHORT; COSTS;

D O I：

10.1111/1475-6773.13211

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

ObjectiveTo investigate whether continuity of care in family practice reduces unplanned hospital use for people with serious mental illness (SMI). Data SourcesLinked administrative data on family practice and hospital utilization by people with SMI in England, 2007-2014. Study DesignThis observational cohort study used discrete-time survival analysis to investigate the relationship between continuity of care in family practice and unplanned hospital use: emergency department (ED) presentations, and unplanned admissions for SMI and ambulatory care-sensitive conditions (ACSC). The analysis distinguishes between relational continuity and management/ informational continuity (as captured by care plans) and accounts for unobserved confounding by examining deviation from long-term averages. Data Collection/Extraction MethodsIndividual-level family practice administrative data linked to hospital administrative data. Principal FindingsHigher relational continuity was associated with 8-11 percent lower risk of ED presentation and 23-27 percent lower risk of ACSC admissions. Care plans were associated with 29 percent lower risk of ED presentation, 39 percent lower risk of SMI admissions, and 32 percent lower risk of ACSC admissions. ConclusionsFamily practice continuity of care can reduce unplanned hospital use for physical and mental health of people with SMI.

引用

页码：1316 / 1325

页数：10

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