Older adults who see the same primary care physician have fewer preventable hospitalizations

Original Research

Background: Continuity of care has been linked with fewer hospitalizations. This study examined whether better continuity is helpful for acute, potentially preventable hospitalizations that might be avoided with regular care. Researchers analyzed data for 54,376 adults aged 45 years and older from the long-term “45 and Up Study” in New South Wales, Australia. Survey responses were linked with Medicare general practitioner claims and hospital admission records from 2007 to 2017. Researchers used a double machine learning approach to separate the effect of continuity of care from the influence of factors such as age, chronic illness, socioeconomic status, and health behaviors.

What This Study Found:

• Over the 11-year period, 27,634 participants (50.8%) had at least one acute potentially preventable hospitalization.
• Higher continuity was associated with fewer acute hospitalizations, and the reduction was larger for acute than for non-acute conditions. Increasing the Continuity of Care Index from the 45th to the 50th percentile was associated with a 9.8% to 23.5% lower probability of an acute preventable hospitalization compared with non-acute preventable hospitalizations, depending on the machine learning model used.

Implications: The findings suggest that strengthening the patient-clinician relationship can help reduce preventable hospital stays.

Continuity of Primary Care and Preventable Hospitalization for Acute Conditions: A Machine Learning-Based Record Linkage Study

Anurag Sharma, PhD, et al

School of Population Health, University of New South Wales, Sydney, New South Wales, Australia