NDLI: The association between multimorbidity and hospitalization is modified by individual demographics and physician continuity of care: a retrospective cohort study

Content Provider	Springer Nature : BioMed Central
Author	Gruneir, Andrea Bronskill, Susan E. Maxwell, Colleen J. Bai, Yu Qing Kone, Anna J. Thavorn, Kednapa Petrosyan, Yelena Calzavara, Andrew Wodchis, Walter P.
Abstract	Background Multimorbidity poses a significant clinical challenge and has been linked to greater health services use, including hospitalization; however, we have little knowledge about the influence of contextual factors on outcomes in this population. Objectives: To describe the extent to which the association between multimorbidity and hospitalization is modified by age, gender, primary care practice model, or continuity of care (COC) among adults with at least one chronic condition. Methods A retrospective cohort study with linked population-based administrative data. Setting: Ontario, Canada. Cohort: All individuals 18 and older with at least one of 16 priority chronic conditions as of April 1, 2009 (baseline). Main Outcome Measures: Any hospitalization, 3 or more hospitalizations, non-medical discharge delay, and 30-day readmission within the 1 year following baseline. Results Of 5,958,514 individuals, 484,872 (8.1 %) experienced 646,347 hospitalizations. There was a monotonic increase in the likelihood of hospitalization and related outcomes with increasing multimorbidity which was modified by age, gender, and COC but not primary care practice model. The effect of increasing multimorbidity was greater in younger adults than older adults and in those with lower COC than with higher COC. The effect of increasing multimorbidity on hospitalization was greater in men than women but reversed for the other outcomes. Conclusions The effect of multimorbidity on hospitalization is influenced by age and gender, important considerations in the development of person-centred care models. Greater continuity of physician care lessened the effect of multimorbidity on hospitalization, further demonstrating the need for care continuity across providers for people with chronic conditions.
Related Links	https://bmchealthservres.biomedcentral.com/counter/pdf/10.1186/s12913-016-1415-5.pdf
Ending Page	9
Page Count	9
Starting Page	1
File Format	HTM / HTML
ISSN	14726963
DOI	10.1186/s12913-016-1415-5
Journal	BMC Health Services Research
Issue Number	1
Volume Number	16
Language	English
Publisher	BioMed Central
Publisher Date	2016-04-27
Access Restriction	Open
Subject Keyword	Public Health Health Administration Health Informatics Nursing Research Chronic conditions Age Sex and gender Continuity of care Readmission
Content Type	Text
Resource Type	Article
Subject	Health Policy

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