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Continuity of Care, Follow-Up Care, and Outcomes among Breast Cancer Survivors

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  • Yun-Yi Chen

    (Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei 10055, Taiwan)

  • Cheng-I Hsieh

    (Division of Hematology and Oncology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei 11031, Taiwan
    Division of Hematology and Oncology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan)

  • Kuo-Piao Chung

    (Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei 10055, Taiwan)

Abstract

This retrospective cohort study examined the effects of care continuity on the utilization of follow-up services and outcome of breast cancer patients (stages I–III) in the post-treatment phase of care. Propensity score matching and generalized estimation equations were used in the analysis of data obtained from national longitudinal databases. The continuity of care index (COCI) was calculated separately for primary care physicians (PCP) and oncologists. Our results revealed that breast cancer survivors with a higher oncology COCI were more likely than those with a lower oncology COCI to use mammography or breast ultrasound during the follow-up period (OR = 1.26, 95% CI: 1.19–1.32; OR = 1.12, 95% CI: 1.06–1.18; respectively). In terms of health outcomes, a higher oncology COCI was associated with a lower likelihood of hospitalization (OR = 0.78, 95% CI: 0.71–0.85) and emergency department use (OR = 0.88, 95% CI: 0.82–0.95). A higher PCP COCI was also associated with a lower likelihood of hospitalization (OR = 0.77, 95% CI: 0.70–0.85) and emergency department use (OR = 0.75, 95% CI: 0.68–0.82). Overall, this study determined that ambulatory care continuity is positively associated with the likelihood of using recommended follow-up care services and negatively associated with adverse health events among breast cancer survivors.

Suggested Citation

  • Yun-Yi Chen & Cheng-I Hsieh & Kuo-Piao Chung, 2019. "Continuity of Care, Follow-Up Care, and Outcomes among Breast Cancer Survivors," IJERPH, MDPI, vol. 16(17), pages 1-16, August.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:17:p:3050-:d:260083
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    References listed on IDEAS

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    1. Mainous III, A.G. & Gill, J.M., 1998. "The importance of continuity of care in the likelihood of future hospitalization: Is site of care equivalent to a primary clinician?," American Journal of Public Health, American Public Health Association, vol. 88(10), pages 1539-1541.
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    Cited by:

    1. Kuang-Tsu Yang & Chun-Hao Yin & Yao-Min Hung & Shih-Ju Huang & Ching-Chih Lee & Tsu-Jen Kuo, 2020. "Continuity of Care Is Associated with Medical Costs and Inpatient Days in Children with Cerebral Palsy," IJERPH, MDPI, vol. 17(8), pages 1-15, April.

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