The association between multimorbidity and hospitalization is modified by individual demographics and physician continuity of care: a retrospective cohort study.
BMC Health Serv Res
; 16: 154, 2016 04 27.
Article
em En
| MEDLINE
| ID: mdl-27122051
ABSTRACT
BACKGROUND:
Multimorbidity poses a significant clinical challenge and has been linked to greater health services use, including hospitalization; however, we have little knowledge about the influence of contextual factors on outcomes in this population.OBJECTIVES:
To describe the extent to which the association between multimorbidity and hospitalization is modified by age, gender, primary care practice model, or continuity of care (COC) among adults with at least one chronic condition.METHODS:
A retrospective cohort study with linked population-based administrative data.SETTING:
Ontario, Canada. COHORT All individuals 18 and older with at least one of 16 priority chronic conditions as of April 1, 2009 (baseline). MAIN OUTCOMEMEASURES:
Any hospitalization, 3 or more hospitalizations, non-medical discharge delay, and 30-day readmission within the 1 year following baseline.RESULTS:
Of 5,958,514 individuals, 484,872 (8.1 %) experienced 646,347 hospitalizations. There was a monotonic increase in the likelihood of hospitalization and related outcomes with increasing multimorbidity which was modified by age, gender, and COC but not primary care practice model. The effect of increasing multimorbidity was greater in younger adults than older adults and in those with lower COC than with higher COC. The effect of increasing multimorbidity on hospitalization was greater in men than women but reversed for the other outcomes.CONCLUSIONS:
The effect of multimorbidity on hospitalization is influenced by age and gender, important considerations in the development of person-centred care models. Greater continuity of physician care lessened the effect of multimorbidity on hospitalization, further demonstrating the need for care continuity across providers for people with chronic conditions.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Readmissão do Paciente
/
Padrões de Prática Médica
/
Comorbidade
/
Doença Crônica
/
Continuidade da Assistência ao Paciente
/
Hospitalização
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article