Effects of continuity of care on emergency department utilization in children with asthma

Shu Tzu Huang, Shiao Chi Wu, Yen-Ni Hung, I. Po Lin

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objectives: To examine whether continuity of ambulatory asthma care can lower asthma-specific emergency department (ED) utilization by children with asthma in Taiwan. Study Design: Retrospective cohort study based on claims data. Methods: We used the Taiwan National Health Insurance Dataset, 2006 to 2009. The study population was new asthma patients aged 0 to 17 years in 2007, and every case was observed for 2 years. We used the Continuity of Care Index (COCI) to calculate the continuity of ambulatory asthma care in the first year, and estimated the asthma-specific ED utilization in the second year. Two-part hurdle regression was used for statistical analysis. Results: The 29,277 patients in our study had an average COCI of 0.68 (± 0.31), and 42.3% of patients had an index of 1. More than 1 in 20 patients-1641 (5.61%)-had at least 1 asthma ED visit, and the mean number of visits per user was 1.46 (± 0.99). After controlling for covariates, the groups with medium and low continuity of ambulatory asthma care had 21% (odds ratio [OR], 1.21; 95% CI, 1.06-1.39) and 38% (OR, 1.38; 95% CI, 1.21-1.58) higher asthma-related ED utilization, respectively, than the group with high COCI. However, among users, the number of ED visits was not statistically correlated to the continuity of ambulatory asthma care. Conclusions: High continuity of ambulatory asthma care can decrease asthma-specific ED utilization risk in children with newly diagnosed asthma in Taiwan. We suggest that providers and the government reinforce the use of follow-up care and education for high-risk groups to improve the continuity of ambulatory asthma care.

Original languageEnglish
Pages (from-to)e31-e37
JournalAmerican Journal of Managed Care
Volume22
Issue number1
Publication statusPublished - Jan 1 2016

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Continuity of Patient Care
Hospital Emergency Service
Asthma
Ambulatory Care
Taiwan
Odds Ratio
Aftercare
National Health Programs

ASJC Scopus subject areas

  • Health Policy

Cite this

Effects of continuity of care on emergency department utilization in children with asthma. / Huang, Shu Tzu; Wu, Shiao Chi; Hung, Yen-Ni; Lin, I. Po.

In: American Journal of Managed Care, Vol. 22, No. 1, 01.01.2016, p. e31-e37.

Research output: Contribution to journalArticle

Huang, Shu Tzu ; Wu, Shiao Chi ; Hung, Yen-Ni ; Lin, I. Po. / Effects of continuity of care on emergency department utilization in children with asthma. In: American Journal of Managed Care. 2016 ; Vol. 22, No. 1. pp. e31-e37.
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abstract = "Objectives: To examine whether continuity of ambulatory asthma care can lower asthma-specific emergency department (ED) utilization by children with asthma in Taiwan. Study Design: Retrospective cohort study based on claims data. Methods: We used the Taiwan National Health Insurance Dataset, 2006 to 2009. The study population was new asthma patients aged 0 to 17 years in 2007, and every case was observed for 2 years. We used the Continuity of Care Index (COCI) to calculate the continuity of ambulatory asthma care in the first year, and estimated the asthma-specific ED utilization in the second year. Two-part hurdle regression was used for statistical analysis. Results: The 29,277 patients in our study had an average COCI of 0.68 (± 0.31), and 42.3{\%} of patients had an index of 1. More than 1 in 20 patients-1641 (5.61{\%})-had at least 1 asthma ED visit, and the mean number of visits per user was 1.46 (± 0.99). After controlling for covariates, the groups with medium and low continuity of ambulatory asthma care had 21{\%} (odds ratio [OR], 1.21; 95{\%} CI, 1.06-1.39) and 38{\%} (OR, 1.38; 95{\%} CI, 1.21-1.58) higher asthma-related ED utilization, respectively, than the group with high COCI. However, among users, the number of ED visits was not statistically correlated to the continuity of ambulatory asthma care. Conclusions: High continuity of ambulatory asthma care can decrease asthma-specific ED utilization risk in children with newly diagnosed asthma in Taiwan. We suggest that providers and the government reinforce the use of follow-up care and education for high-risk groups to improve the continuity of ambulatory asthma care.",
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