The association between continuity of care and the severity of diabetes-related complications

Abstract

Purpose: To assess the association between continuity of care and severity of diabetes-related complications for geriatric diabetic patients.

Methods: A retrospective study using 2009-2013 Taiwan’s National Health Insurance Research Database one million beneficiary version were conducted. Utilization data of 3,885 geriatric patients who newly had type 2 diabetes were studied. Five-year Continuity of Care Index (COCI) and the adapted Diabetes Complications Severity Index (aDCSI) of each subject were calculated. A Group-based trajectory modeling (GBTM) was used to distinguish patients with similar five-year COCI into different trajectories. A general estimating equation(GEE) was used to assess the association between COCI trajectories and aDCSI.

Results: The ratio of male to female in this study was 2:3. At the time of inclusion, the average age was 71.79 (4.65) years old. GBTM subjects can be divided into four different trajectories according to their COCI: low-level continuity of care trajectories, increasing continuity of care trajectories, decreasing continuity of care trajectory, and high-level continuity of care trajectory. After GEE analysis, the high continuity of care trajectories were associated with a significant decrease in aDCSI score.

Conclusion: The results of this study suggested better continuity of care was associated with less severity of diabetes-related complications for geriatric patients.

Keywords

Diabetes complications severity index / Continuity of care index / Geriatric diabetes / Group-based trajectory modeling

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