ArticleBMJ open2019
Prevalence of care fragmentation among outpatients attending specialist clinics in a regional hospital in Singapore: a cross-sectional study.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
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- Review
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- Transitional Care Program in Reducing Acute Hospital Utilization in Singapore.Healthcare (Basel, Switzerland) · 2024Article
- Patient perspectives of diabetes care in primary care networks in Singapore: a mixed-methods study.BMC health services research · 2023Article
- Reproductive care in Thai women with diabetes mellitus: a descriptive cross-sectional study.Reproductive health · 2023Article
- Supporting carers to improve patient safety and maintain their well-being in transitions from mental health hospitals to the community: A prioritisation nominal group technique.Health expectations : an international journal of public participation in health care and health policy · 2023Article
- Multimorbidity and determinants for initiating outpatient trajectories: A population-based study.BMC public health · 2023Article
- Community hospitals of the future-challenges and opportunities.Frontiers in health services · 2023Article
- Fragmentation of ambulatory care among older adults: an exhaustive database study in an ageing city in Japan.BMJ open · 2022Article
- Long-Term Outpatient Care and Rehospitalizations in Patients after Cardiac Electrotherapy Device Implantation.Medicina (Kaunas, Lithuania) · 2022Article
- Trajectories in Outpatient Care for People with Multimorbidity: A Population-Based Register Study in Denmark.Clinical epidemiology · 2022Article
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Authors and funding
4 authors.
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Abstract
objectiveTo measure the extent of multispecialty care fragmentation among outpatients receiving specialist care and identify associated risk factors for fragmented care.
designA retrospective cross-sectional study.
settingSpecialist outpatient clinics (SOCs) in a Singapore regional hospital.
participantsA total of 40 333 patients aged 21 and above with at least two SOC visits in the year 2016. Data for 146 792 physician consultation visits were used in the analysis and visits for allied health services and medical procedures were excluded. OUTCOME MEASURES: The Fragmentation of Care Index (FCI) was used to measure care fragmentation for specialist outpatients. Log-linear regression with stepwise selection was used to investigate the association between FCI and patient age, gender, race and Most Frequently Visited Specialty (MFVS), controlling for number of different specialities seen.
resultsAbout 36% experienced fragmented care (FCI >0) and their mean FCI was 0.70 (SD=0.20). FCI was found to be positively associated with age (p<0.001). Patients who most frequently visited Haematology, Endocrinology and Anaesthesiology specialities were associated with more fragmented care while those who most frequently visited Medical Oncology, Ophthalmology and Orthopaedics Surgery specialities were associated with less fragmented care.
conclusionMultispecialty care fragmentation was found to be moderately high in the outpatient specialist clinics and was found to be associated with patients' age and certain medical specialties. With an ageing population and a rising prevalence of multimorbidity, healthcare providers should seek to eliminate unnecessary referrals to reduce the extent of care fragmentation.
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