Impact of family practice continuity of care on unplanned hospital use for people with serious mental illness

TY - JOUR

T1 - Impact of family practice continuity of care on unplanned hospital use for people with serious mental illness

AU - Ride, Jemimah

AU - Kasteridis, Panagiotis

AU - Gutacker, Nils

AU - Doran, Timothy

AU - Rice, Nigel

AU - Gravelle, Hugh

AU - Kendrick, Tony

AU - Mason, Anne

AU - Goddard, Maria

AU - Siddiqi, Najma

AU - Gilbody, Simon

AU - Williams, Rachael

AU - Aylott, Lauren

AU - Jacobs, Rowena

AU - Dare, Ceri

N1 - © 2019 The Authors

PY - 2019/11/19

Y1 - 2019/11/19

N2 - Objective: To investigate whether continuity of care in family practice reduces unplanned hospital use for people with serious mental illness (SMI). Data Sources Linked administrative data on family practice and hospital utilization by people with SMI in England, 2007-2014. Study Design: This observational cohort study used discrete-time survival analysis to investigate the relationship between continuity of care in family practice and unplanned hospital use: emergency department (ED) presentations, and unplanned admissions for SMI and ambulatory care-sensitive conditions (ACSC). The analysis distinguishes between relational continuity and management/ informational continuity (as captured by care plans) and accounts for unobserved confounding by examining deviation from long-term averages. Data Collection/Extraction Methods: Individual-level family practice administrative data linked to hospital administrative data. Principal Findings: Higher relational continuity was associated with 8-11 percent lower risk of ED presentation and 23-27 percent lower risk of ACSC admissions. Care plans were associated with 29 percent lower risk of ED presentation, 39 percent lower risk of SMI admissions, and 32 percent lower risk of ACSC admissions. Conclusions: Family practice continuity of care can reduce unplanned hospital use for physical and mental health of people with SMI.

AB - Objective: To investigate whether continuity of care in family practice reduces unplanned hospital use for people with serious mental illness (SMI). Data Sources Linked administrative data on family practice and hospital utilization by people with SMI in England, 2007-2014. Study Design: This observational cohort study used discrete-time survival analysis to investigate the relationship between continuity of care in family practice and unplanned hospital use: emergency department (ED) presentations, and unplanned admissions for SMI and ambulatory care-sensitive conditions (ACSC). The analysis distinguishes between relational continuity and management/ informational continuity (as captured by care plans) and accounts for unobserved confounding by examining deviation from long-term averages. Data Collection/Extraction Methods: Individual-level family practice administrative data linked to hospital administrative data. Principal Findings: Higher relational continuity was associated with 8-11 percent lower risk of ED presentation and 23-27 percent lower risk of ACSC admissions. Care plans were associated with 29 percent lower risk of ED presentation, 39 percent lower risk of SMI admissions, and 32 percent lower risk of ACSC admissions. Conclusions: Family practice continuity of care can reduce unplanned hospital use for physical and mental health of people with SMI.

KW - continuity of care;

KW - family practice;

KW - hospital care;

KW - serious mental illness;

U2 - 10.1111/1475-6773.13211

DO - 10.1111/1475-6773.13211

M3 - Article

SN - 0017-9124

VL - 54

SP - 1316

EP - 1325

JO - Health services research

JF - Health services research

ER -