Clinical Edge

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Continuity of Care in Elderly Patients with ACO

Health Policy; ePub 2018 Nov 15; Kao, Tseng, et al

Elderly patients with asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) can benefit from increasing continuity of care (COC) in disease management, a new study found. The retrospective cohort study included 1,141 ACO patients aged ≥65 years during 2005‒2011 who were observed and followed for 2 years. Researchers used the Bice and Boxerman COC index (COCI) to evaluate COC by considering ambulatory care visits due to COPD or asthma in the first year; emergency department (ED) visits and hospitalization for COPD or asthma were identified in the subsequent year. The Cox model was used the estimate the hazard ratio for ED visits and hospital admissions due to COPD or asthma. They found:

  • The average COCI was 0.55.
  • 21.3% of patients received outpatient care from a single physician.
  • Patients with low and median COC had higher risk of ED visits (adjusted HR [aHR], 2.80 and 2.69) and hospital admissions (aHR, 1.80 and 1.72).


Kao YH, Tseng TS, Ng YY, Wu SC. Association between continuity of care and emergency department visits and hospitalization in senior adults with asthma-COPD overlap. [Published online ahead of print November 15, 2018]. Health Policy. doi:10.1016/j.healthpol.2018.11.005.