HealthDay News — For Medicare beneficiaries with congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD) and type 2 diabetes, continuity of care is associated with differences in costs, emergency department use and complications, according to researchers.

In adjusted analyses, each 0.1-unit increase in the continuity of care index correlated with episode of care costs that were 4.7%, 6.3% and 5.1% lower for CHF, COPD and type 2 diabetes, respectively, Peter S. Hussey, PhD, from the RAND Corporation in Santa Monica, Calif., and colleagues reported in JAMA Internal Medicine.

They reviewed insurance claims data for a 5% sample of Medicare beneficiaries experiencing a 12-month episode of care. Participants included 53,488 patients with CHF, 76,520 with COPD and 166,654 with type 2 diabetes.

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Hospitalizations, emergency department visits, complications, and costs of care associated with the Bice-Boxerman continuity of care (COC) index were assessed.

For each 0.1 increase in continuity of care, CHF, COPD and type 2 diabetes also correlated with lower odds of inpatient hospitalizations (OR 0.94, 0.95 and 0.95, respectively), ED visits (OR 0.92, 0.93 and 0.94, respectively) and complications (OR range, 0.92 to 0.96 for three complication types), after multivariate adjustment.

“Modest differences in care continuity for Medicare beneficiaries are associated with sizable differences in costs, use and complications,” the researchers wrote.


  1. Hussey PS et al. JAMA Intern Med. 2014; doi:10.1001/jamainternmed.2014.245.