Continuity of Care, Medication Adherence, and Health Care Outcomes Among Patients With Newly Diagnosed Type 2 Diabetes
- 1 March 2013
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Medical Care
- Vol. 51 (3), 231-237
- https://doi.org/10.1097/mlr.0b013e31827da5b9
Abstract
Background: The effects of continuity of care (COC) on health care outcomes are well established. However, the mechanism of this association is not fully understood. Objective: The objective of this study was to examine the relationship between COC and medication adherence, as well as to investigate the mediating effect of medication adherence on the association between COC and health care outcomes, in patients with newly diagnosed type 2 diabetes. Research Design and Subjects: This study utilized a longitudinal design and included a 7-year follow-up period from 2002 to 2009 under a universal health insurance program in Taiwan. Patients aged 18 years or older who were first diagnosed with type 2 diabetes in 2002 were included in the study. Random intercept models were conducted to assess the temporal relationship between COC, medication adherence, and health care outcomes. Results: Patients with high or intermediate COC scores were more likely to be adherent to medications than those with low COC scores [odds ratio (OR), 3.37; 95% confidence interval (CI), 3.15–3.60 and OR, 1.84; 95% CI, 1.74–1.94, respectively]. In addition, the association between COC and health care outcomes was partly mediated by better medication adherence in patients with newly diagnosed type 2 diabetes. Conclusions: Improving the COC for patients with type 2 diabetes may result in higher medication adherence and better health care outcomes.Keywords
This publication has 35 references indexed in Scilit:
- Continuity of Care for Elderly Patients with Diabetes Mellitus, Hypertension, Asthma, and Chronic Obstructive Pulmonary Disease in KoreaJournal of Korean Medical Science, 2010
- Continuity of diabetes care is associated with avoidable hospitalizations: evidence from Taiwan's National Health Insurance schemeInternational Journal for Quality in Health Care, 2009
- Chronic Illness with Complexity: Implications for Performance Measurement of Optimal Glycemic ControlJournal of General Internal Medicine, 2007
- Physician-Patient Relationship and Medication Compliance: A Primary Care InvestigationAnnals of Family Medicine, 2004
- Taiwan’s New National Health Insurance Program: Genesis And Experience So FarHealth Affairs, 2003
- Measures of Continuity of CareMedical Care, 1986
- The moderator–mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations.Journal of Personality and Social Psychology, 1986
- The central role of the propensity score in observational studies for causal effectsBiometrika, 1983
- Measuring Provider Continuity in Ambulatory CareMedical Care, 1979
- A Quantitative Measure of Continuity of CareMedical Care, 1977