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Research ArticleOriginal Research

Association between Continuity of Care and Health-Related Quality of Life

Elizabeth A. Bayliss, Jennifer L. Ellis, Jo Ann Shoup, Deanna B. McQuillan, John F. Steiner and Chan Zeng
The Journal of the American Board of Family Medicine March 2017, 30 (2) 205-212; DOI: https://doi.org/10.3122/jabfm.2017.02.160225
Elizabeth A. Bayliss
From the Institute for Health Research, Kaiser Permanente Colorado, Denver (EAB, JLE, JAS, DBM, JFS, CZ); the Department of Family Medicine, University of Colorado School of Medicine, Aurora (EAB); and the Department of Internal Medicine, University of Colorado School of Medicine, Aurora (JFS).
MD, MSPH
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Jennifer L. Ellis
From the Institute for Health Research, Kaiser Permanente Colorado, Denver (EAB, JLE, JAS, DBM, JFS, CZ); the Department of Family Medicine, University of Colorado School of Medicine, Aurora (EAB); and the Department of Internal Medicine, University of Colorado School of Medicine, Aurora (JFS).
MSPH
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Jo Ann Shoup
From the Institute for Health Research, Kaiser Permanente Colorado, Denver (EAB, JLE, JAS, DBM, JFS, CZ); the Department of Family Medicine, University of Colorado School of Medicine, Aurora (EAB); and the Department of Internal Medicine, University of Colorado School of Medicine, Aurora (JFS).
PhD, MSW
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Deanna B. McQuillan
From the Institute for Health Research, Kaiser Permanente Colorado, Denver (EAB, JLE, JAS, DBM, JFS, CZ); the Department of Family Medicine, University of Colorado School of Medicine, Aurora (EAB); and the Department of Internal Medicine, University of Colorado School of Medicine, Aurora (JFS).
MA
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John F. Steiner
From the Institute for Health Research, Kaiser Permanente Colorado, Denver (EAB, JLE, JAS, DBM, JFS, CZ); the Department of Family Medicine, University of Colorado School of Medicine, Aurora (EAB); and the Department of Internal Medicine, University of Colorado School of Medicine, Aurora (JFS).
MD, MPH
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Chan Zeng
From the Institute for Health Research, Kaiser Permanente Colorado, Denver (EAB, JLE, JAS, DBM, JFS, CZ); the Department of Family Medicine, University of Colorado School of Medicine, Aurora (EAB); and the Department of Internal Medicine, University of Colorado School of Medicine, Aurora (JFS).
PhD
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Abstract

Background: Patient-reported outcomes (PROs) are considered potential quality metrics for patients with multiple chronic medical conditions (MCC). Although continuity of care (COC) is an essential MCC care process, the association between common PROs and COC is unknown.

Methods: We assessed baseline and two-year follow-up self-reported health status, physical, and emotional well-being, and COC in seniors with MCC. Using mixed effects models with repeated measures adjusting for age, gender, and morbidity, we assessed each outcome as a function of COC.

Results: Of 2,078 seniors, 961 completed the initial survey and 806 completed follow-up. On a 0–100 scale, mean (sd) baseline self-reported health status, physical well-being, and emotional well-being were 48.7 (22.0), 36.4 (11.4), and 54.8 (9.0). On a 0 to 1 scale, mean baseline and 2-year COC were 0.24 (sd 0.22) and 0.22 (0.18). Follow-up self-reported health status, physical well-being, and emotional well-being were 48.8 (23.1), 36.5 (11.5), and 55.3 (8.8). In adjusted primary and secondary analyses using all available data, there were no associations between any outcomes and COC.

Conclusion: Given the measurement burden of quality assessment, negative associations between potential quality metrics and care processes are informative. Systematic assessment of PROs can inform patient-centered MCC care. However, PRO scores should be used with caution as quality measures.

  • Chronic Disease
  • Comorbidity
  • Continuity of Care
  • Follow-up Studies
  • Health Status
  • Patient-Reported Outcome Measures
  • Quality of Life
  • Quality of Health Care
  • Self Report
  • Surveys and Questionnaires
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The Journal of the American Board of Family     Medicine: 30 (2)
The Journal of the American Board of Family Medicine
Vol. 30, Issue 2
March-April 2017
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Association between Continuity of Care and Health-Related Quality of Life
Elizabeth A. Bayliss, Jennifer L. Ellis, Jo Ann Shoup, Deanna B. McQuillan, John F. Steiner, Chan Zeng
The Journal of the American Board of Family Medicine Mar 2017, 30 (2) 205-212; DOI: 10.3122/jabfm.2017.02.160225

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Association between Continuity of Care and Health-Related Quality of Life
Elizabeth A. Bayliss, Jennifer L. Ellis, Jo Ann Shoup, Deanna B. McQuillan, John F. Steiner, Chan Zeng
The Journal of the American Board of Family Medicine Mar 2017, 30 (2) 205-212; DOI: 10.3122/jabfm.2017.02.160225
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Keywords

  • Chronic Disease
  • Comorbidity
  • Continuity of Care
  • Follow-Up Studies
  • Health Status
  • Patient-Reported Outcome Measures
  • Quality of Life
  • Quality of Health Care
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