Association of Continuity of Care With Health Care Utilization and Expenditures Among Patients Discharged Home After Stroke or Transient Ischemic Attack.
Med Care
; 62(4): 270-276, 2024 Apr 01.
Article
en En
| MEDLINE
| ID: mdl-38447009
ABSTRACT
OBJECTIVES:
To examine the association of prestroke continuity of care (COC) with postdischarge health care utilization and expenditures. STUDY POPULATION The study population included 2233 patients with a diagnosis of stroke or a transient ischemic attack hospitalized in one of 41 hospitals in North Carolina between March 2016 and July 2019 and discharged directly home from acute care.METHODS:
COC was assessed from linked Centers for Medicare and Medicaid Services Medicare claims using the Modified, Modified Continuity Index. Logistic regressions and 2-part models were used to examine the association of prestroke primary care COC with postdischarge health care utilization and expenditures.RESULTS:
Relative to patients in the first (lowest) COC quartile, patients in the second and third COC quartiles were more likely [21% (95% CI 8.5%, 33.5%) and 33% (95% CI 20.5%, 46.1%), respectively] to have an ambulatory care visit within 14 days. Patients in the highest COC quartile were more likely to visit a primary care provider but less likely to see a stroke specialist. Highest as compared with lowest primary care COC quartile was associated with $45 lower (95% CI $14, $76) average expenditure for ambulatory care visits within 30 days postdischarge. Patients in the highest, as compared with the lowest, primary care COC quartile were 36% less likely (95% CI 8%, 64%) to be readmitted within 30 days postdischarge and spent $340 less (95% CI $2, $678) on unplanned readmissions.CONCLUSIONS:
These findings underscore the importance of primary care COC received before stroke hospitalization to postdischarge care and expenditures.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Ataque Isquémico Transitorio
/
Accidente Cerebrovascular
Límite:
Aged
/
Humans
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Med Care
Año:
2024
Tipo del documento:
Article
País de afiliación:
Nueva Caledonia