ArticleJournal of general internal medicine2014
The intersection of patient complexity, prescriber continuity and acute care utilization.
Article in Journal of general internal medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
24 citing papers in PubMed.
- A Reflection on Current Definitions of Critical Care and Critical Illness-A Narrative Review of the Literature.Nursing in critical care · 2026Review
- Evaluating Provider and Pharmacy Discordance in Potential Calcium Channel Blocker-Loop Diuretic Prescribing Cascade.Drugs & aging · 2024Article
- QT-Prolonging Antibiotics, Serum-to-Dialysate Potassium Gradient, and Risk of Sudden Cardiac Death Among Patients Receiving Maintenance Hemodialysis.Kidney medicine · 2023Article
- Implications of Under-Reporting Medication Side Effects: Beta-Blockers in Heart Failure as a Case Example.Drugs & aging · 2023Article
- When is caring sharing? Primary care provider interdependence and continuity of care.JAAPA : official journal of the American Academy of Physician Assistants · 2023Article
- N-of-1 trials to facilitate evidence-based deprescribing: Rationale and case study.British journal of clinical pharmacology · 2022Review
- Outpatient care fragmentation in Veterans Affairs patients at high-risk for hospitalization.Health services research · 2022Article
- Definition of patient complexity in adults: A narrative review.Journal of multimorbidity and comorbidity · 2022Review
- Continuity of care and health care cost among community-dwelling older adult veterans living with dementia.Health services research · 2021Article
- Patterns of clinic switching and continuity of medication for opioid use disorder in a Medicaid-enrolled population.Drug and alcohol dependence · 2021Article
- Delivering Complex Care: Designing for Patients and Physicians.Journal of general internal medicine · 2021Article
- The Initial Use of the Home Medication Experience Questionnaire (HOME-Q) in Community-Based Pharmacy.Journal of patient experience · 2020Article
- Physician Perspectives on Deprescribing Cardiovascular Medications for Older Adults.Journal of the American Geriatrics Society · 2020Article
- Deprescribing in the context of multiple providers: understanding patient preferences.The American journal of managed care · 2019Article
- Continuity of Medication Management among Adults with Schizophrenia and Comorbid Cardiometabolic Conditions.Journal of pharmaceutical health services research : an official journal of the Royal Pharmaceutical Society of Great Britain · 2018Article
- Prescriber Continuity and Disease Control of Older Adults.Medical care · 2017Article
- Do Medical Homes Offer Improved Diabetes Care for Medicaid Enrollees with Co-occurring Schizophrenia?Journal of health care for the poor and underserved · 2017Article
- Relationship Between Medication Adherence and Distance to Dispensing Pharmacies and Prescribers Among an Urban Medicaid Population with Diabetes Mellitus.Pharmacotherapy · 2016Article
- Does Greater Continuity of Veterans Administration Primary Care Reduce Emergency Department Visits and Hospitalization in Older Veterans?Journal of the American Geriatrics Society · 2015Article
- Patient perspectives on having multiple versus single prescribers of chronic disease medications: results of a qualitative study in a veteran population.BMC health services research · 2014Article
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Authors and funding
7 authors.
Funding
Abstract
backgroundCare continuity is considered a critical characteristic of high-performing health systems. Few studies have examined the continuity of medication management of complex patients, who often have multiple providers and complex medication regimens. PURPOSE: The purpose of this study was to characterize patient factors associated with having more prescribers and the association between number of prescribers and acute care utilization. DESIGN AND SUBJECTS: A retrospective cohort study was conducted of 7,933 Veterans with one to four cardiometabolic conditions (diabetes, hypertension, hyperlipidemia or congestive heart failure) and prescribed medications for these conditions in 2008. MAIN MEASURES: The association between number of cardiometabolic conditions and prescribers was modeled using Poisson regression. The number of cardiometabolic conditions and number of prescribers were modeled to predict probability of inpatient admission, probability of emergency room (ER) visits, and number of ER visits among ER users. Demographic characteristics, number of cardiometabolic medications and comorbidities were included as covariates in all models. KEY
resultsPatients had more prescribers if they had more cardiometabolic conditions (p < 0.001). The adjusted odds of an ER visit increased with the number of prescribers (two prescribers, Odds Ratio (OR) = 1.16; three prescribers, OR = 1.21; 4+ prescribers, OR = 1.39), but not with the number of conditions. Among ER users, the number of ER visits was neither associated with the number of prescribers nor the number of conditions. The adjusted odds of an inpatient admission increased with the number of prescribers (two prescribers, OR = 1.27; three prescribers, OR = 1.30; 4+ prescribers, OR = 1.34), but not with the number of conditions.
conclusionsHaving more prescribers was associated with greater healthcare utilization for complex patients, despite adjustment for the number of conditions and medications. The number of prescribers may be an appropriate target for reducing acute care utilization by complex patients.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.