Better continuity of care reduces costs for diabetic patients

Am J Manag Care. 2011 Jun;17(6):420-7.


Objective: To examine the effects of continuity of care on healthcare utilization and expenses for patients with diabetes mellitus.

Study design: Longitudinal study based on claims data.

Methods: Data on healthcare utilization and expenses from a 7-year period (2000-2006) were gathered from claims data of the Taiwanese universal health insurance system. The continuity of care index (COCI) was analyzed, and the values were classified into 3 levels. Outcome variables included the likelihood of hospitalization and emergency department visit, pharmaceutical expenses for diabetes-related conditions, and total healthcare expenses for diabetes-related conditions. A generalized estimating equation that considered the effects of repeated measures for the same patients was applied to examine the effects of continuity of care on healthcare utilization and expenses.

Results: Compared with patients who had low COCI scores, patients with high or medium COCI scores were less likely to be hospitalized for diabetes related conditions (odds ratio [OR] 0.26, 95% confidence interval [CI] 0.25, 0.27, and OR 0.58, 95% CI 0.56, 0.59, respectively) or to have diabetes-related emergency department visits (OR 0.34, 95% CI 0.33, 0.36, and OR 0.64, 95% CI 0.62, 0.66, respectively). Patients with low COCI scores incurred $126 more in pharmaceutical expenses than patients with high COCI scores. Furthermore, patients with high COCI scores had greater savings ($737) in total healthcare expenses for diabetes-related conditions than patients with low COCI scores.

Conclusion: Better continuity of care was associated with less healthcare utilization and lower healthcare expenses for diabetic patients. Improving continuity of care might benefit diabetic patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Continuity of Patient Care / economics*
  • Cost-Benefit Analysis
  • Diabetes Complications / economics
  • Diabetes Complications / prevention & control
  • Diabetes Mellitus / economics*
  • Diabetes Mellitus / therapy
  • Female
  • Health Services / economics*
  • Health Services / statistics & numerical data*
  • Humans
  • Insurance Claim Review
  • Longitudinal Studies
  • Male
  • Middle Aged
  • National Health Programs / economics
  • National Health Programs / statistics & numerical data
  • Physician-Patient Relations
  • Taiwan