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High continuity of care reduces mortality among those with COPD

High continuity of care reduced the risk for all-cause mortality among patients with chronic obstructive pulmonary disease, according to results of a population-based retrospective cohort study.

Home oxygen therapy and number of hospital admissions also may predict mortality in this patient population, results showed.

“Further research on the associations between continuity of care and various health care outcomes — adjusting for potential confounders such as income, education and health behaviors — is needed,” Kyoung Hee Cho, of the department of public health and graduate school at Yonsei University in Seoul, South Korea, and colleagues wrote.

Cho and colleagues evaluated data from 3,090 adults — aged 40 years or older — with COPD included in a nationwide insurance claims database. All patients developed COPD in 2005 and survived for at least 1 year after diagnosis.

Follow-up continued until 2012.

Nearly two-thirds (60.8%) of patients died before the end of the study period.

Those with a high continuity of care — defined as a continuity of care index of at least 0.75 — survived for a median 3.92 years. Those with a low continuity of care — defined as a continuity of care index of less than 0.75 — survived for a median 2.58 years.

A multivariate time-dependent analysis showed low continuity of care was associated with an increased risk for all-cause mortality (HR = 1.22; 95% CI, 1.09-1.36). Study participants who did not receive oxygen therapy at home (HR = 1.23; 95% CI, 1.01-1.49) also were at increased risk for all-cause mortality.

In addition, researchers observed an association between the number of hospital admissions and all-cause mortality. The trend persisted for those with one admission (HR = 1.38; 95% CI, 1.21-1.59), two admissions (HR = 1.63; 95% CI, 1.34-1.99) and three or more admissions (HR = 1.96; 95% CI, 1.63-2.36). – by Jeff Craven

Disclosure: The researchers report no relevant financial disclosures.