ArticleHealth services research2021
Continuity of care and health care cost among community-dwelling older adult veterans living with dementia.
Article in Health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed.
- Effect of continuity of care on medical expenditures for hypertensive patients in high-altitude areas of China.Health policy and planning · 2026Article
- Continuity of primary care and end-of-life care costs in dementia: a retrospective cohort study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026Article
- Home Time Following Emergency Department Visits Among People With Dementia.JAMA network open · 2025Article
- "The first transition is from resident to patient": understanding the decisional needs of long-term care residents preparing for hospital transitions.The Gerontologist · 2025Article
- "I know you didn't want to stay": emergency department conversations about disposition for people living with dementia.The Gerontologist · 2025Article
- Discontinuity of social support among US adults with cognitive impairment before and after the confirmed diagnosis of dementia: a matched ambidirectional cohort study.BMC medicine · 2025Article
- Older adults living with dementia enrolled in similar Medicare Advantage plans compared to those without dementia.Alzheimer's & dementia. Behavior & socioeconomics of aging · 2025Article
- Role of general practitioner-led rural community hospitals in Sweden: a qualitative study.BMJ open · 2025Article
- Racial/Ethnic Disparities in Hospital Readmission and Frequent Hospitalizations Among Medicare Beneficiaries With Alzheimer's Disease and Related Dementia: Traditional Medicare Versus Medicare Advantage.The journals of gerontology. Series B, Psychological sciences and social sciences · 2024Article
- End-of-Life Healthcare Utilization in Lewy Body Dementia.Journal of Alzheimer's disease : JAD · 2024Article
- Shared Disposition Decision-Making in the Emergency Department for Persons Living with Dementia.Journal of geriatric emergency medicine · 2023Article
- The associations of continuity of care with inpatient, outpatient, and total medical care costs among older adults with urinary incontinence.BMC health services research · 2023Article
- Emergency department utilization and presenting chief complaints by Veterans living with dementia.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2023Observational
- Continuity of care for older adults in a Canadian long-term care setting: a qualitative study.BMC health services research · 2022Article
- Effects of continuity of care on hospitalizations and healthcare costs in older adults with dementia.BMC geriatrics · 2022Article
- Association between continuity of care (COC), healthcare use and costs: what can we learn from claims data? A rapid review.BMC health services research · 2022Review
- Continuity of care and multimorbidity in the 50+ Swiss population: An analysis of claims data.SSM - population health · 2022Article
- Association of Continuity of General Practitioner Care with Utilisation of General Practitioner and Specialist Services in China: A Mixed-Method Study.Healthcare (Basel, Switzerland) · 2021Article
- Continuity of care and health care cost among community-dwelling older adult veterans living with dementia.Health services research · 2021Article
- Changes in healthcare utilization and costs following enrollment in an interprofessional primary care clinic designed to address clinical and social vulnerabilities.Journal of interprofessional careArticle
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo estimate the causal impact of continuity of care (COC) on total, institutional, and noninstitutional cost among community-dwelling older veterans with dementia. DATA SOURCES: Combined Veterans Health Administration (VHA) and Medicare data in Fiscal Years (FYs) 2014-2015. STUDY
designFY 2014 COC was measured by the Bice-Boxerman Continuity of Care (BBC) index on a 0-1 scale. FY 2015 total combined VHA and Medicare cost, institutional cost of acute inpatient, emergency department [ED], long-/short-stay nursing home, and noninstitutional long-term care (LTC) cost for medical (like skilled-) and social (like unskilled-) services were assessed controlling for covariates. An instrumental variable for COC (change of residence by more than 10 miles) was used to account for unobserved health confounders. DATA COLLECTION: Community-dwelling veterans with dementia aged 66 and older, enrolled in Traditional Medicare (N = 102 073). PRINCIPAL
findingsMean BBC in FY 2014 was 0.32; mean total cost in FY 2015 was $35 425. A 0.1 higher BBC resulted in (a) $4045 lower total cost; (b) $1597 lower acute inpatient cost, $119 lower ED cost, $4368 lower long-stay nursing home cost; (c) $402 higher noninstitutional medical LTC and $764 higher noninstitutional social LTC cost. BBC had no impact on short-stay nursing home cost.
conclusionsCOC is an effective approach to reducing total health care cost by supporting noninstitutional care and reducing institutional care.
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Registered trials
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.