The association between continuity of care and the overuse of medical procedures

Max J. Romano, Jodi Segal, Craig Pollack

Research output: Contribution to journalArticle

Abstract

IMPORTANCE Both the overuse of unnecessary medical procedures and poor continuity of care are thought to contribute to high health care spending and poor patient outcomes. OBJECTIVE To investigate the association between care continuity and use of potentially unnecessary procedures. DESIGN, SETTING, AND PARTICIPANTS Observational retrospective cohort (n = 1 208 250 patients > 65 years) using 5%Medicare fee-for-service claims from 2008. MAIN OUTCOMES AND MEASURES We evaluated continuity using the Bice-Boxerman continuity of care index.We measured overuse using a previously validated set of 19 potentially overused procedures. RESULTS Altogether, 14.7%of patients received at least 1 potentially overused procedure during the calendar year. For each 0.1 increase in the continuity score (0.4 SDs), patients had 0.93 times the odds of receiving overused procedures than those with lower scores (95%CI, 0.93-0.94). Higher continuity was significantly associated with lower odds of 9 procedures (Holm-Bonferroni corrected P <.02 was significant: 6 of 13 diagnostic tests [with ORs, 0.84-0.99; P <.001] and 3 therapeutic procedures [with ORs 0.81-0.87; P

Original languageEnglish (US)
Pages (from-to)1148-1154
Number of pages7
JournalJAMA Internal Medicine
Volume175
Issue number7
DOIs
StatePublished - Jul 1 2015

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Continuity of Patient Care
Unnecessary Procedures
Fee-for-Service Plans
Medicare
Routine Diagnostic Tests
Outcome Assessment (Health Care)
Medical Overuse
Delivery of Health Care

ASJC Scopus subject areas

  • Internal Medicine
  • Medicine(all)

Cite this

The association between continuity of care and the overuse of medical procedures. / Romano, Max J.; Segal, Jodi; Pollack, Craig.

In: JAMA Internal Medicine, Vol. 175, No. 7, 01.07.2015, p. 1148-1154.

Research output: Contribution to journalArticle

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