Dr. Tung-Tseng, associate professor of Louisiana State University Health Sciences Center School of Public Health behavioral and community health sciences, explains that the objective of the research was to investigate associations between continuity of care (COC) and emergency department (ED) visits and hospitalization for chronic obstructive pulmonary disease (COPD) or asthma among elderly adults with asthma-COPD overlap (ACO).
The study was performed using the Taiwan National Health Insurance research database. A total of 1141 ACO patients aged ≥65 years during 2005–2011 were observed and followed for two years. The Bice and Boxerman COC index (COCI) was used to evaluate COC by considering ambulatory care visits due to COPD or asthma in the first year; ED visits and hospitalization for COPD or asthma were identified in the subsequent year, respectively. The COCI was divided into three levels(COCI < 0.3= low, 0.3 ≤ COCI<1=medium, COCI = 1=high). The Cox model was used to estimate the hazard ratio (HR) for ED visits and hospital admissions due to COPD or asthma. The team concluded that increasing COC is beneficial for elderly patients with ACO in disease management. Policy-makers could create effective pay-for-performance programs for the elderly ACO population to enhance COC and improve care outcomes.