ArticleJournal of the American Geriatrics Society2015
Does Greater Continuity of Veterans Administration Primary Care Reduce Emergency Department Visits and Hospitalization in Older Veterans?
Article in Journal of the American Geriatrics Society, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers.
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Who cites it
32 citing papers in PubMed, 53 citations in OpenAlex.
- Use of emergency medical services by adults with developmental disabilities receiving integrated or usual care.Disability and health journal · 2026Article
- Categorizing continuity of care measures and why you have (probably) been doing it wrong: a methodological discussion and recommendations for researchers.The European journal of health economics : HEPAC : health economics in prevention and care · 2026Article
- Continuity of Primary Care and Preventable Hospitalization for Acute Conditions: A Machine Learning-Based Record Linkage Study.Annals of family medicine · 2025Article
- Gaps in the coordination of care for older adults with or at risk for cardiovascular disease.The American journal of managed care · 2025Article
- Area-Level socioeconomic disadvantage and access to primary care: A rapid review.Health affairs scholar · 2025Review
- Association of polydoctoring and mortality among persons over 85 years with multimorbidity: a prospective cohort study in Japan.BJGP open · 2024Article
- Travel Burden as a Measure of Healthcare Access and the Impact of Telehealth within the Veterans Health Administration.Journal of general internal medicine · 2023Observational
- Ambulatory Care Fragmentation, Emergency Department Visits, and Race: a Nationwide Cohort Study in the U.S.Journal of general internal medicine · 2023Article
- Outpatient Care Fragmentation and Acute Care Utilization in Veterans Affairs Home-Based Primary Care.JAMA network open · 2022Article
- Fragmentation of ambulatory care among older adults: an exhaustive database study in an ageing city in Japan.BMJ open · 2022Article
- Physician- versus practice-level primary care continuity and association with outcomes in Medicare beneficiaries.Health services research · 2022Article
- Outpatient care fragmentation in Veterans Affairs patients at high-risk for hospitalization.Health services research · 2022Article
- Continuity of care, measurement and association with hospital admission and mortality: a registry-based longitudinal cohort study.BMJ open · 2021Article
- Impact of New York State's Health Home program on access to care among patients with diabetes.BMJ open diabetes research & care · 2021Article
- Differences between recorded diagnoses of patients of an emergency department and office-hours primary care doctors: a register-based study in a Finnish town.International journal of circumpolar health · 2021Article
- Associations between regular GP contact, diabetes monitoring and glucose control: an observational study using general practice data.BMJ open · 2021Observational
- Does a policy that requires adherence to a regular primary care physician improve the actual adherence of patients?Israel journal of health policy research · 2021Article
- Continuity of care and health care cost among community-dwelling older adult veterans living with dementia.Health services research · 2021Article
- Regularity and Continuity of GP Contacts and Use of Statins Amongst People at Risk of Cardiovascular Events.Journal of general internal medicine · 2021 · on this mapObservational
- Ambulatory Care Fragmentation and Incident Stroke.Journal of the American Heart Association · 2021Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo evaluate the association between longitudinal continuity of primary care and use of emergency department (ED) and inpatient care in older veterans.
designRetrospective cohort study.
settingDepartment of Veterans Affairs (VA) primary care clinics in 15 regional health networks, ED and inpatient facilities.
participantsMedicare-eligible veterans aged 65 and older with three or more VA primary care visits during fiscal year 2007-08 (baseline period) (N = 243,881). MEASUREMENTS: Two measures of longitudinal continuity were estimated using merged VA-Centers for Medicare and Medicaid Services administrative data: Usual Provider of Continuity (UPC) and Modified Modified Continuity Index (MMCI). Negative binomial and multivariable logistic regression models were used to predict ED use and inpatient hospitalization during fiscal year 2009, controlling for sociodemographic characteristics, medical and psychiatric comorbidity, and baseline use of health services.
resultsThe incidence rate ratio (IRR) of ED visits was greater in patients with high (IRR = 1.05, 95% confidence interval (CI) = 1.02-1.07), intermediate (IRR = 1.04, 95% CI = 1.02-1.07), and low (IRR = 1.06, 95% CI = 1.03-1.09) UPC than in those with very high UPC (0.9-1.0). Patients with high (odds ratio (OR) = 1.04, 95% CI = 1.01-1.07), intermediate (OR = 1.03, 95% CI = 1.00-1.06), and low (OR = 1.04, 95% CI = 1.01-1.07) UPC were also more likely to be hospitalized during follow-up. Results were similar for MMCI continuity scores.
conclusionEven slightly lower primary care provider (PCP) continuity was associated with modestly greater ED use and inpatient hospitalization in older veterans. Additional efforts should be made to schedule older adults with their assigned PCP whenever possible.
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