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International Journal of Public Health

, Volume 60, Issue 4, pp 505–513 | Cite as

Continuity of care trajectories and emergency room use among patients with diabetes

  • Hui-Ying Tsai
  • Yiing-Jenq Chou
  • Christy Pu
Original Article

Abstract

Objectives

To analyze the pattern of continuity of care (COC) using trajectory analysis for a group of patients newly diagnosed with diabetes, and determine whether various trajectories lead to distinct patient outcomes.

Methods

We used the Taiwan National Health Insurance claims database. Newly diagnosed patients with diabetes in 2005 totaling 4367 were included in this study. All patients were followed up to 2011. We identified groups of COC trajectories using trajectory analysis. We subsequently determined whether various COC trajectories were associated with the frequency of total and diabetes-related emergency room (ER) use using negative binomial models.

Results

We discovered five distinct COC trajectories for our newly diagnosed diabetes sample based on trajectory analysis. The early-seeker group had the lowest IRR for total ER visits (IRR = 0.56, P < 0.001), followed by the high-maintainer group (IRR = 0.67, P < 0.001). Similar results were obtained for diabetes-specific ER use.

Conclusions

We identified various COC trajectories for diabetes patients. Chronic disease patients may seek a suitable physician by compromising care continuity at the onset of disease progression and exhibit favorable outcome.

Keywords

Continuity of care (COC) Group-based trajectory analysis Emergency room (ER) use Diabetes 

Notes

Acknowledgments

This study is funded by the Taiwan National Science Council, grant number: 101-2410-H-010-007.

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Copyright information

© Swiss School of Public Health 2015

Authors and Affiliations

  1. 1.Institute of Hospital and Healthcare AdministrationNational Yang-Ming UniversityTaipeiTaiwan
  2. 2.Department of Public HealthNational Yang-Ming UniversityTaipeiTaiwan

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