ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2020
Coordination of Care Is Associated With Survival and Health Care Utilization in a Population-Based Study of Patients With Cirrhosis.
Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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The trial behind it
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- EASL position paper on palliative care in advanced chronic liver disease.JHEP reports : innovation in hepatology · 2026Guideline
- Steatotic liver disease trajectory: A holistic EASL guidance on the multidisciplinary approach to screening and patient management.JHEP reports : innovation in hepatology · 2026Review
- Social and Functional Risk Patterns and All-Cause Mortality Among US Adults with Chronic Liver Disease.Medical sciences (Basel, Switzerland) · 2026Article
- Pain, uncertainty, and lack of clinical support drive emergency department utilization in cirrhosis: A qualitative study.Hepatology communications · 2026Article
- Coordinated care program in the Polish primary healthcare: insights into the early implementation.Archives of public health = Archives belges de sante publique · 2025Article
- High Hospitalization Rates and Risk Factors Among Frail Patients With Cirrhosis: A 10-year Population-based Cohort Study.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2025Article
- Inadequate Dietary Education and Poor Adherence to a High Protein, Low Sodium Diet in Cirrhosis: Mixed Methods Approach.Digestive diseases and sciences · 2024Article
- The benefits of a team approach to cirrhosis care.Canadian liver journal · 2023Article
- Distinct health care use patterns of patients with chronic gastrointestinal diseases.The American journal of managed care · 2023Observational
- Exploring provider roles, continuity, and mental models in cirrhosis care: A qualitative study.Canadian liver journal · 2023Article
- Identifying Alcohol Use Disorder in Patients With Cirrhosis Reduces 30-Days Readmission Rate.Alcohol and alcoholism (Oxford, Oxfordshire) · 2022Article
- Inpatient Gastroenterology Consultation and Outcomes of Cirrhosis-Related Hospitalizations in Two Large National Cohorts.Digestive diseases and sciences · 2022Article
- The Impact of Social Workers in Cirrhosis Care: a Systematic Review.Current treatment options in gastroenterology · 2022Review
- Burdensome Transitions of Care for Patients with End-Stage Liver Disease and Their Caregivers.Digestive diseases and sciences · 2021Article
- Eliciting and Understanding Primary Care and Specialist Mental Models of Cirrhosis Care: A Cognitive Task Analysis Study.Canadian journal of gastroenterology & hepatology · 2021Article
- The COVID-19 pandemic will have a long-lasting impact on the quality of cirrhosis care.Journal of hepatology · 2020Review
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
BACKGROUND &
aimsImproving care coordination for patients with high-intensity specialty care needs, such as cirrhosis, can increase quality of healthcare and reduce utilization. We examined the relationship between care concentration and risk of hospitalization for patients with cirrhosis.
methodsWe performed a retrospective cohort study of 26,006 Medicare enrollees with cirrhosis with more than 4 outpatient visits over 180 days. We collected data on 2 validated measures of care concentration: the usual provider of care (UPC) index, a measure of the proportion of a patient's total visits that is with their most regularly seen provider, and the continuity of care (COC) index, a measure of care density and dispersion. Both use a scale of 0 to 1. Time to death or liver transplantation was evaluated using a multivariable Cox proportional hazards model. Hospital days and 30-day readmissions per person-year were evaluated in negative binomial models.
resultsThe median COC score was 0.40 (interquartile range, 0.26-0.60) and the median UPC was 0.60 (interquartile range, 0.50-0.80). Increasing care concentration (based on COC and UPC index scores) were associated with increased mortality and hospitalization. The highest 25th percentile of COC and UPC scores were associated with adjusted hazard ratios for mortality of 1.20 (95% CI, 1.10-1.31) and 1.14 (95% CI, 1.06-1.24), adjusted incidence rate ratios for hospital days of 1.12 (95% CI, 1.02-1.23) and 1.10 (95% CI, 1.01-1.20), and adjusted incidence rate ratios for readmissions of 1.19 (95% CI, 1.06-1.34) and 1.12 (95% CI, 1.00-1.25), respectively.
conclusionsBased on a study of Medicare enrollees, care concentration is low among patients with cirrhosis. However, increased concentration is associated with increased mortality and increased healthcare utilization. These data indicate that, to optimize outcomes for persons with cirrhosis, team-based care might be necessary.
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Registered trials
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