The Association between Continuity of Care and All-Cause Mortality in Patients with Newly Diagnosed Obstructive Pulmonary Disease: A Population-Based Retrospective Cohort Study, 2005-2012Report as inadecuate




The Association between Continuity of Care and All-Cause Mortality in Patients with Newly Diagnosed Obstructive Pulmonary Disease: A Population-Based Retrospective Cohort Study, 2005-2012 - Download this document for free, or read online. Document in PDF available to download.

Background

The disease burden is increasing for chronic obstructive pulmonary disease COPD due to increasing of the growth rate of prevalence and mortality. But the empirical researches are a little for COPD that studied the association between continuity of care and death and about predictors effect on mortality.

Objective

To investigate the association between continuity of care COC and chronic obstructive pulmonary disease COPD mortality and to identify other mortality-related factors in COPD patients.

Methods

We conducted a longitudinal, population-based retrospective cohort study in adult patients with COPD from 2002 to 2012 using a nationwide health insurance claims database. The study sample included individuals aged 40 years and over who developed COPD in 2005 and survived until 2006. We performed a Cox proportional hazard regression analysis with COC analyzed as a time-dependent covariate.

Results

Of the 3,090 participants, 60.8% died before the end of study N = 1,879. The median years of survival for individuals with high COC COC index≥0.75 was 3.92, and that for patients with low COC COC index<0.75 was 2.58 in a Kaplan Meier analysis. In a multivariate, time-dependent analysis, low COC was associated with a 22% increased risk of all-cause mortality HR, 1.22; 95% CI, 1.09–1.36. Not receiving oxygen therapy at home was associated with a 23% increased risk of all-cause mortality HR, 1.23; 95% CI, 1.01–1.49. Moreover, the risk of all-cause mortality for individuals who admitted one time increased 38% HR, 1.38; 95% CI, 1.21–1.59, two times was 63% HR, 1.63; 95% CI, 1.34–1.99 and 3+ times was 96% HR, 1.96; 95% CI, 1.63–2.36 relative to the reference group no admission.

Conclusions

High COC was associated with a decreased risk of all-cause mortality. In addition, home oxygen therapy and number of hospital admissions may predict mortality in patients with COPD.



Author: Kyoung Hee Cho , Young Sam Kim , Chung Mo Nam , Tae Hyun Kim, Sun Jung Kim, Kyu-Tae Han, Eun-Cheol Park

Source: http://plos.srce.hr/



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