Continuity of care of Swiss residents aged 50+: a longitudinal study using claims data

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Etat: Public
Version: Final published version
Licence: CC BY 4.0
ID Serval
serval:BIB_3E3368E9BB3D
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Continuity of care of Swiss residents aged 50+: a longitudinal study using claims data
Périodique
Integrated Healthcare Journal
Auteur⸱e⸱s
Nicolet Anna, Peytremann-Bridevaux Isabelle, Wagner Joël, Perraudin Clémence, Bagnoud Christophe, Marti Joachim
ISSN
2399-5351
Statut éditorial
Publié
Date de publication
2022
Peer-reviewed
Oui
Volume
4
Numéro
e000105
Langue
anglais
Résumé
Background
Continuity of care (COC) should be measured for healthcare quality monitoring and evaluation and is a key process indicator for integrated care. Measurement of COC using routinely collected data is widespread, but there is no consensus on which indicator to use and the relevant time horizon to apply. Information about COC is especially warranted in highly fragmented healthcare systems, such as in Switzerland. Our study aimed to compare COC measures in Swiss residents aged 50+ obtained with various indices and time horizons.
Methods
Using insurance claims data, we computed and compared several commonly used visit-based Continuity of Care Indices (COCIs): Bice-Boxerman Index, Usual Provider of Care, Herfindahl-Hirschman Index, Modified, Modified Continuity Index and Modified Continuity Index, based on all doctor visits and on primary care (PC) visits only. Indices were computed over short (1 year) and medium (4 years) terms.
Results
The mean indices based on all visits varied between 0.51 and 0.77, while PC indices presented less variation with a median of 1.00 for all but one index. Indices focusing on a variety of individual providers decreased with time horizon, while indices focusing on the overall number of visits and providers showed the opposite trend. These findings suggest fundamental differences in the interpretation of COCIs.
Conclusions
Broad COC appeared moderately low in Switzerland, although comparable to other countries, and PC COC was close to one. The choice of indices and time horizon influenced their interpretation. Understanding these differences is key to select the appropriate index for the monitoring of COC.
Open Access
Oui
Financement(s)
Fonds national suisse / 407440_183447
Création de la notice
01/05/2023 9:39
Dernière modification de la notice
02/05/2023 7:09
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