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

Jemimah Ride, Panagiotis Kasteridis, Nils Gutacker, Tim Doran, Nigel Rice, Hugh Gravelle, Tony Kendrick, Anne Mason, Maria Goddard, Najma Siddiqi, Simon Gilbody, Rachael Williams, Lauren Aylott, Ceri Dare, Rowena Jacobs

Research output: Contribution to journalArticleResearchpeer-review

23 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)1316-1325
Number of pages10
JournalHealth Services Research
Volume54
Issue number6
DOIs
Publication statusPublished - Dec 2019
Externally publishedYes

Keywords

  • continuity of care
  • family practice
  • hospital care
  • serious mental illness

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