Study Finds Continuity of Care Reduces Costs, Mortality, Morbidity

As cost containment becomes increasingly important in healthcare, the findings of a recent study in the Annals of Family Medicine on the impacts of continuity of care could have an impact on how healthcare systems deliver care.

Researchers led by Dong Wook Shin, MD, DrPH, MBA, with Seoul National University Hospital in South Korea, found that continuity of care is associated with reduced mortality, morbidity, and healthcare expenditures.

“Continuity of care is considered a core element of high-quality primary care, but its impact on mortality and health care costs is unclear,” Dr Wook Shin and colleagues wrote. “We aimed to determine the impact of continuity of care on mortality, costs, and health outcomes in patients with newly diagnosed cardiovascular risk factors.”

The authors studied the impact of continuity of care on survival and healthcare costs in patients with newly diagnosed cardiovascular risk factors. More than 47,000 patients with newly diagnosed hypertension, diabetes, hypercholesterolemia, or their complications in 2003 or 2004 were included in the study.

The investigators studied outcomes over 5 years of follow-up, measuring overall mortality, cardiovascular mortality, incident cardiovascular events, and healthcare costs. They measured continuity of care with 3 commonly used indices: most frequent provider continuity; modified, modified continuity index; and continuity-of-care index.

“While our findings cannot be generalized to other conditions, our results suggest that continuity of care is a robust predictor of outcomes in patients for conditions with available effective preventive interventions,” the authors wrote.

Patients who see the same physician are more likely to adopt better self-management behaviors and are more likely to adhere to medication, according to the results of the study. Meanwhile, lower continuity of care was associated with increased inpatient and outpatient days and costs.

Unfortunately, healthcare management changes and an increasingly fragmented healthcare delivery system are forcing discontinuity in the United States and elsewhere, according to the researchers.

“Health care systems should be designed to support long-term trusting relationships between patients and physicians, and health policies should encourage patients to concentrate their care with one physician,” the authors concluded.