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Published in: BMC Health Services Research 1/2016

Open Access 01-12-2016 | Research article

Effect of continuity of care on health-related quality of life in adult patients with hypertension: a cohort study in China

Authors: Ting Ye, Xiaowei Sun, Wenxi Tang, Yudong Miao, Yan Zhang, Liang Zhang

Published in: BMC Health Services Research | Issue 1/2016

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Abstract

Background

Continuity of care is widely considered a principle of primary care that decreases healthcare utilization and mortality. However, the effect of continuity of care on health-related quality of life (HRQoL) for adult patients with hypertension remains unclear.

Methods

To further evaluate the effect of continuity of care, we implemented a cohort study among hypertensive patients aged over 35 years (n = 1200) in six townships in Qianjiang District, Chongqing, China, between 2012 and 2014. The study ultimately included 1079 participants. The continuity of care index was calculated using claim-based longitudinal data obtained from hypertension follow-up service records. The baseline and endline survey-based data, tested by the SF-36 scale, were used to assess HRQoL. To control selection bias and examine the effect of continuity of care, a kernel-based propensity score matching difference-in-differences (DID) method was used. Additionally, descriptive statistics, chi-squared test, and Mann–Whitney nonparametric test were used to summarize characteristics, evaluate proportional differences, and analyze statistical differences, respectively.

Results

Our results showed that patients in the high continuity of care group presented greater improvement in both Physical Component Summary (PCS, DID = 5.192 ± 1.970, p < 0.001) and Mental Component Summary (MCS, DID = 7.900 ± 1.815, p = 0.008) than those in the low continuity of care group. Moreover, patients in the high continuity of care group showed significant improvement in physical functioning, role-physical, general health, role-emotional, and mental health.

Conclusions

Our findings indicate that a long-term physician-patient relationship may improve HRQoL in patients with hypertension. However, more unified measurement tools are needed to evaluate continuity of care. Further studies should include more study settings.
Literature
2.
3.
go back to reference Romaire MA, Haber SG, Wensky SG, McCall N. Primary care and specialty providers: an assessment of continuity of care, utilization, and expenditures. Med Care. 2014;52(12):1042–9.PubMed Romaire MA, Haber SG, Wensky SG, McCall N. Primary care and specialty providers: an assessment of continuity of care, utilization, and expenditures. Med Care. 2014;52(12):1042–9.PubMed
4.
go back to reference Cheng SH, Chen CC, Hou YF. A longitudinal examination of continuity of care and avoidable hospitalization: evidence from a universal coverage health care system. Arch Intern Med. 2010;170(18):1671–7.CrossRefPubMed Cheng SH, Chen CC, Hou YF. A longitudinal examination of continuity of care and avoidable hospitalization: evidence from a universal coverage health care system. Arch Intern Med. 2010;170(18):1671–7.CrossRefPubMed
5.
go back to reference Hong JS, Kang HC, Kim J. Continuity of care for elderly patients with diabetes mellitus, hypertension, asthma, and chronic obstructive pulmonary disease in Korea. J Korean Med Sci. 2010;25(9):1259–71.CrossRefPubMedPubMedCentral Hong JS, Kang HC, Kim J. Continuity of care for elderly patients with diabetes mellitus, hypertension, asthma, and chronic obstructive pulmonary disease in Korea. J Korean Med Sci. 2010;25(9):1259–71.CrossRefPubMedPubMedCentral
6.
go back to reference Cheng SH, Hou YF, Chen CC. Does continuity of care matter in a health care system that lacks referral arrangements? Health Policy Plann. 2011;26(2):157–62.CrossRef Cheng SH, Hou YF, Chen CC. Does continuity of care matter in a health care system that lacks referral arrangements? Health Policy Plann. 2011;26(2):157–62.CrossRef
7.
go back to reference Cho KH, Lee SG, Jun B, Jung BY, Kim JH, Park EC. Effects of continuity of care on hospital admission in patients with type 2 diabetes: analysis of nationwide insurance data. BMC Health Serv Res. 2015;15:107.CrossRefPubMedPubMedCentral Cho KH, Lee SG, Jun B, Jung BY, Kim JH, Park EC. Effects of continuity of care on hospital admission in patients with type 2 diabetes: analysis of nationwide insurance data. BMC Health Serv Res. 2015;15:107.CrossRefPubMedPubMedCentral
8.
go back to reference Chen CC, Chen SH. Better continuity of care reduces costs for diabetic patients. Am J Manag Care. 2011;17(6):420–7.PubMed Chen CC, Chen SH. Better continuity of care reduces costs for diabetic patients. Am J Manag Care. 2011;17(6):420–7.PubMed
9.
go back to reference Marchinko S, Clarke D. The Wellness Planner: empowerment, quality of life, and continuity of care in mental illness. Arch Psychiatr Nurs. 2011;25(4):284–93.CrossRefPubMed Marchinko S, Clarke D. The Wellness Planner: empowerment, quality of life, and continuity of care in mental illness. Arch Psychiatr Nurs. 2011;25(4):284–93.CrossRefPubMed
10.
go back to reference De Maeseneer JM, De Prins L, Gosset C, Heyerick J. Provider continuity in family medicine: does it make a difference for total health care costs? Ann Fam Med. 2003;1(3):144–8.CrossRefPubMedPubMedCentral De Maeseneer JM, De Prins L, Gosset C, Heyerick J. Provider continuity in family medicine: does it make a difference for total health care costs? Ann Fam Med. 2003;1(3):144–8.CrossRefPubMedPubMedCentral
11.
go back to reference Hoertel N, Limosin F, Leleu H. Poor longitudinal continuity of care is associated with an increased mortality rate among patients with mental disorders: results from the French National Health Insurance Reimbursement Database. Eur Psychiatry. 2014;29(6):358–64.CrossRefPubMed Hoertel N, Limosin F, Leleu H. Poor longitudinal continuity of care is associated with an increased mortality rate among patients with mental disorders: results from the French National Health Insurance Reimbursement Database. Eur Psychiatry. 2014;29(6):358–64.CrossRefPubMed
12.
go back to reference Shin DW, Cho J, Yang HK, Park JH, Lee H, Kim H, Oh J, Hwang S, Cho B, Guallar E. Impact of continuity of care on mortality and health care costs: a nationwide cohort study in Korea. Ann Fam Med. 2014;12(6):534–41.CrossRefPubMedPubMedCentral Shin DW, Cho J, Yang HK, Park JH, Lee H, Kim H, Oh J, Hwang S, Cho B, Guallar E. Impact of continuity of care on mortality and health care costs: a nationwide cohort study in Korea. Ann Fam Med. 2014;12(6):534–41.CrossRefPubMedPubMedCentral
13.
go back to reference Cheng SH, Chen CC. Effects of continuity of care on medication duplication among the elderly. Med Care. 2014;52(2):149–56.CrossRefPubMed Cheng SH, Chen CC. Effects of continuity of care on medication duplication among the elderly. Med Care. 2014;52(2):149–56.CrossRefPubMed
14.
go back to reference Chen CC, Tseng CH, Cheng SH. Continuity of care, medication adherence, and health care outcomes among patients with newly diagnosed type 2 diabetes: a longitudinal analysis. Med Care. 2013;51(3):231–7.CrossRefPubMed Chen CC, Tseng CH, Cheng SH. Continuity of care, medication adherence, and health care outcomes among patients with newly diagnosed type 2 diabetes: a longitudinal analysis. Med Care. 2013;51(3):231–7.CrossRefPubMed
17.
go back to reference Beattie P, Dowda M, Turner C, Michener L, Nelson R. Longitudinal continuity of care is associated with high patient satisfaction with physical therapy. Phys Ther. 2005;85(10):1046–52.PubMed Beattie P, Dowda M, Turner C, Michener L, Nelson R. Longitudinal continuity of care is associated with high patient satisfaction with physical therapy. Phys Ther. 2005;85(10):1046–52.PubMed
18.
go back to reference Weyrauch KF. Does continuity of care increase HMO patients’ satisfaction with physician performance? J Am Board Fam Pract. 1996;9(1):31–6.PubMed Weyrauch KF. Does continuity of care increase HMO patients’ satisfaction with physician performance? J Am Board Fam Pract. 1996;9(1):31–6.PubMed
19.
go back to reference Robles S, Anderson GF. Continuity of care and its effect on prescription drug use among Medicare beneficiaries with hypertension. Med Care. 2011;49(5):516–21.CrossRefPubMed Robles S, Anderson GF. Continuity of care and its effect on prescription drug use among Medicare beneficiaries with hypertension. Med Care. 2011;49(5):516–21.CrossRefPubMed
20.
go back to reference Panattoni L, Stone A, Chung S, Tai-Seale M. Patients report better satisfaction with part-time primary care physicians, despite less continuity of care and access. J Gen Intern Med. 2015;30(3):327–33.CrossRefPubMed Panattoni L, Stone A, Chung S, Tai-Seale M. Patients report better satisfaction with part-time primary care physicians, despite less continuity of care and access. J Gen Intern Med. 2015;30(3):327–33.CrossRefPubMed
21.
go back to reference Hanninen J, Takala J, Keinanen-Kiukaanniemi S. Good continuity of care may improve quality of life in Type 2 diabetes. Diabetes Res Clin Pract. 2001;51(1):21–7.CrossRefPubMed Hanninen J, Takala J, Keinanen-Kiukaanniemi S. Good continuity of care may improve quality of life in Type 2 diabetes. Diabetes Res Clin Pract. 2001;51(1):21–7.CrossRefPubMed
22.
go back to reference Gulliford MC, Naithani S, Morgan M. Continuity of care and intermediate outcomes of type 2 diabetes mellitus. Fam Pract. 2007;24(3):245–51.CrossRefPubMed Gulliford MC, Naithani S, Morgan M. Continuity of care and intermediate outcomes of type 2 diabetes mellitus. Fam Pract. 2007;24(3):245–51.CrossRefPubMed
23.
go back to reference He J. Hypertension in China: a large and increasing public health challenge. J Hypertens. 2016;34(1):29–31.CrossRefPubMed He J. Hypertension in China: a large and increasing public health challenge. J Hypertens. 2016;34(1):29–31.CrossRefPubMed
24.
go back to reference Wang J, Zhang L, Wang F, Liu L, Wang H. Prevalence, awareness, treatment, and control of hypertension in China: results from a national survey. Am Journal Hypertens. 2014;27(11):1355–61.CrossRef Wang J, Zhang L, Wang F, Liu L, Wang H. Prevalence, awareness, treatment, and control of hypertension in China: results from a national survey. Am Journal Hypertens. 2014;27(11):1355–61.CrossRef
26.
go back to reference Tang W, Sun X, Zhang Y, Ye T, Zhang L. How to build and evaluate an integrated health care system for chronic patients: study design of a clustered randomised controlled trial in rural China. Int J Integr Care. 2015;15:e7.CrossRef Tang W, Sun X, Zhang Y, Ye T, Zhang L. How to build and evaluate an integrated health care system for chronic patients: study design of a clustered randomised controlled trial in rural China. Int J Integr Care. 2015;15:e7.CrossRef
27.
28.
go back to reference Smedby O, Eklund G, Eriksson EA, Smedby B. Measures of continuity of care. A register-based correlation study. Med Care. 1986;24(6):511–8.CrossRefPubMed Smedby O, Eklund G, Eriksson EA, Smedby B. Measures of continuity of care. A register-based correlation study. Med Care. 1986;24(6):511–8.CrossRefPubMed
29.
go back to reference Ribka JP. Building systems to measure continuity of care. Nurs Case Manag. 1998;3(4):151–4.PubMed Ribka JP. Building systems to measure continuity of care. Nurs Case Manag. 1998;3(4):151–4.PubMed
30.
31.
go back to reference Uijen AA, Heinst CW, Schellevis FG, van den Bosch WJ, van de Laar FA, Terwee CB, Schers HJ. Measurement properties of questionnaires measuring continuity of care: a systematic review. PLoS One. 2012;7(7):e42256.CrossRefPubMedPubMedCentral Uijen AA, Heinst CW, Schellevis FG, van den Bosch WJ, van de Laar FA, Terwee CB, Schers HJ. Measurement properties of questionnaires measuring continuity of care: a systematic review. PLoS One. 2012;7(7):e42256.CrossRefPubMedPubMedCentral
32.
go back to reference Roos LL, Roos NP, Gilbert P, Nicol JP. Continuity of care: does it contribute to quality of care? Med Care. 1980;18(2):174–84.CrossRefPubMed Roos LL, Roos NP, Gilbert P, Nicol JP. Continuity of care: does it contribute to quality of care? Med Care. 1980;18(2):174–84.CrossRefPubMed
33.
go back to reference Christakis DA, Mell L, Wright JA, Davis R, Connell FA. The association between greater continuity of care and timely measles-mumps-rubella vaccination. Am J Public Health. 2000;90(6):962–5.CrossRefPubMedPubMedCentral Christakis DA, Mell L, Wright JA, Davis R, Connell FA. The association between greater continuity of care and timely measles-mumps-rubella vaccination. Am J Public Health. 2000;90(6):962–5.CrossRefPubMedPubMedCentral
34.
go back to reference Ware JE. SF-36 health survey manual and interpretation guide. Boston: New England Medical Center; 1993. p. 107. Ware JE. SF-36 health survey manual and interpretation guide. Boston: New England Medical Center; 1993. p. 107.
35.
go back to reference Ware JJ, Kosinski M, Bayliss MS, McHorney CA, Rogers WH, Raczek A. Comparison of methods for the scoring and statistical analysis of SF-36 health profile and summary measures: summary of results from the Medical Outcomes Study. Med Care. 1995;33(4 Suppl):S264–79. Ware JJ, Kosinski M, Bayliss MS, McHorney CA, Rogers WH, Raczek A. Comparison of methods for the scoring and statistical analysis of SF-36 health profile and summary measures: summary of results from the Medical Outcomes Study. Med Care. 1995;33(4 Suppl):S264–79.
36.
go back to reference Ware JJ, Gandek B. Overview of the SF-36 Health Survey and the International Quality of Life Assessment (IQOLA) Project. J Clin Epidemiol. 1998;51(11):903–12.CrossRefPubMed Ware JJ, Gandek B. Overview of the SF-36 Health Survey and the International Quality of Life Assessment (IQOLA) Project. J Clin Epidemiol. 1998;51(11):903–12.CrossRefPubMed
37.
go back to reference Gebel M, Vossemer J. The impact of employment transitions on health in Germany. A difference-in-differences propensity score matching approach. Soc Sci Med. 2014;108:128–36.CrossRefPubMed Gebel M, Vossemer J. The impact of employment transitions on health in Germany. A difference-in-differences propensity score matching approach. Soc Sci Med. 2014;108:128–36.CrossRefPubMed
38.
go back to reference Rosenthal MB, Sinaiko AD, Eastman D, Chapman B, Partridge G. Impact of the Rochester Medical Home Initiative on Primary Care Practices, Quality, Utilization, and Costs. Med Care. 2015;53(11):967–73.PubMed Rosenthal MB, Sinaiko AD, Eastman D, Chapman B, Partridge G. Impact of the Rochester Medical Home Initiative on Primary Care Practices, Quality, Utilization, and Costs. Med Care. 2015;53(11):967–73.PubMed
39.
go back to reference Sari N, Osman M. The effects of patient education programs on medication use among asthma and COPD patients: a propensity score matching with a difference-in-difference regression approach. BMC Health Serv Res. 2015;15:332.CrossRefPubMedPubMedCentral Sari N, Osman M. The effects of patient education programs on medication use among asthma and COPD patients: a propensity score matching with a difference-in-difference regression approach. BMC Health Serv Res. 2015;15:332.CrossRefPubMedPubMedCentral
40.
go back to reference Maluccio JA, Palermo T, Kadiyala S, Rawat R. Improving Health-Related Quality of Life among People Living with HIV: Results from an Impact Evaluation of a Food Assistance Program in Uganda. PLoS One. 2015;10(8):e135879.CrossRef Maluccio JA, Palermo T, Kadiyala S, Rawat R. Improving Health-Related Quality of Life among People Living with HIV: Results from an Impact Evaluation of a Food Assistance Program in Uganda. PLoS One. 2015;10(8):e135879.CrossRef
41.
go back to reference Rubin DB. Using Propensity Scores to Help Design Observational Studies: Application to the Tobacco Litigation. Health Serv Outcome Res Methodol. 2001;2:169–88. Rubin DB. Using Propensity Scores to Help Design Observational Studies: Application to the Tobacco Litigation. Health Serv Outcome Res Methodol. 2001;2:169–88.
42.
go back to reference Chu HY, Chen CC, Cheng SH. Continuity of care, potentially inappropriate medication, and health care outcomes among the elderly: evidence from a longitudinal analysis in Taiwan. Med Care. 2012;50(11):1002–9.CrossRefPubMed Chu HY, Chen CC, Cheng SH. Continuity of care, potentially inappropriate medication, and health care outcomes among the elderly: evidence from a longitudinal analysis in Taiwan. Med Care. 2012;50(11):1002–9.CrossRefPubMed
43.
go back to reference Bentler SE, Morgan RO, Virnig BA, Wolinsky FD. Do claims-based continuity of care measures reflect the patient perspective? Med Care Res Rev. 2014;71(2):156–73.CrossRefPubMed Bentler SE, Morgan RO, Virnig BA, Wolinsky FD. Do claims-based continuity of care measures reflect the patient perspective? Med Care Res Rev. 2014;71(2):156–73.CrossRefPubMed
44.
go back to reference Wasson JH, Sauvigne AE, Mogielnicki RP, Frey WG, Sox CH, Gaudette C, Rockwell A. Continuity of outpatient medical care in elderly men. A randomized trial. JAMA. 1984;252(17):2413–17.CrossRefPubMed Wasson JH, Sauvigne AE, Mogielnicki RP, Frey WG, Sox CH, Gaudette C, Rockwell A. Continuity of outpatient medical care in elderly men. A randomized trial. JAMA. 1984;252(17):2413–17.CrossRefPubMed
45.
go back to reference Jee SH, Cabana MD. Indices for continuity of care: A systematic review of the literature. Med Care Res Rev. 2006;63(2):158–88.CrossRefPubMed Jee SH, Cabana MD. Indices for continuity of care: A systematic review of the literature. Med Care Res Rev. 2006;63(2):158–88.CrossRefPubMed
Metadata
Title
Effect of continuity of care on health-related quality of life in adult patients with hypertension: a cohort study in China
Authors
Ting Ye
Xiaowei Sun
Wenxi Tang
Yudong Miao
Yan Zhang
Liang Zhang
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2016
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-016-1673-2

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