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Continuity of care and its associations with self-reported health, clinical characteristics and follow-up services after percutaneous coronary intervention
AIMS: Complexity of care in patients with coronary artery disease is increasing, due to ageing, improved treatment, and more specialised care. Patients receive care from various healthcare providers in many settings. Still, few studies have evaluated continuity of care across primary and secondary c...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6993348/ https://www.ncbi.nlm.nih.gov/pubmed/32005235 http://dx.doi.org/10.1186/s12913-020-4908-1 |
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author | Valaker, Irene Fridlund, Bengt Wentzel-Larsen, Tore Nordrehaug, Jan Erik Rotevatn, Svein Råholm, Maj-Britt Norekvål, Tone M. |
author_facet | Valaker, Irene Fridlund, Bengt Wentzel-Larsen, Tore Nordrehaug, Jan Erik Rotevatn, Svein Råholm, Maj-Britt Norekvål, Tone M. |
author_sort | Valaker, Irene |
collection | PubMed |
description | AIMS: Complexity of care in patients with coronary artery disease is increasing, due to ageing, improved treatment, and more specialised care. Patients receive care from various healthcare providers in many settings. Still, few studies have evaluated continuity of care across primary and secondary care levels for patients after percutaneous coronary intervention (PCI). This study aimed to determine multifaceted aspects of continuity of care and associations with socio-demographic characteristics, self-reported health, clinical characteristics and follow-up services for patients after PCI. METHODS: This multi-centre prospective cohort study collected data at baseline and two-month follow-up from medical records, national registries and patient self-reports. Univariable and hierarchical regressions were performed using the Heart Continuity of Care Questionnaire total score as the dependent variable. RESULTS: In total, 1695 patients were included at baseline, and 1318 (78%) completed the two-month follow-up. Patients stated not being adequately informed about lifestyle changes, medication and follow-up care. Those experiencing poorer health status after PCI scored significantly worse on continuity of care. Patients with ST-segment elevation myocardial infarction scored significantly better on informational and management continuity than those with other cardiac diagnoses. The regression analyses showed significantly better continuity (P ≤ 0.034) in patients who were male, received written information from hospital, were transferred to another hospital before discharge, received follow-up from their general practitioner or had sufficient consultation time after discharge from hospital. CONCLUSION: Risk factors for sub-optimal continuity were identified. These factors are important to patients, healthcare providers and policy makers. Action should be taken to educate patients, reconcile discharge plans and organise post-discharge services. Designing pathways with an interdisciplinary approach and shared responsibility between healthcare settings is recommended. |
format | Online Article Text |
id | pubmed-6993348 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-69933482020-02-04 Continuity of care and its associations with self-reported health, clinical characteristics and follow-up services after percutaneous coronary intervention Valaker, Irene Fridlund, Bengt Wentzel-Larsen, Tore Nordrehaug, Jan Erik Rotevatn, Svein Råholm, Maj-Britt Norekvål, Tone M. BMC Health Serv Res Research Article AIMS: Complexity of care in patients with coronary artery disease is increasing, due to ageing, improved treatment, and more specialised care. Patients receive care from various healthcare providers in many settings. Still, few studies have evaluated continuity of care across primary and secondary care levels for patients after percutaneous coronary intervention (PCI). This study aimed to determine multifaceted aspects of continuity of care and associations with socio-demographic characteristics, self-reported health, clinical characteristics and follow-up services for patients after PCI. METHODS: This multi-centre prospective cohort study collected data at baseline and two-month follow-up from medical records, national registries and patient self-reports. Univariable and hierarchical regressions were performed using the Heart Continuity of Care Questionnaire total score as the dependent variable. RESULTS: In total, 1695 patients were included at baseline, and 1318 (78%) completed the two-month follow-up. Patients stated not being adequately informed about lifestyle changes, medication and follow-up care. Those experiencing poorer health status after PCI scored significantly worse on continuity of care. Patients with ST-segment elevation myocardial infarction scored significantly better on informational and management continuity than those with other cardiac diagnoses. The regression analyses showed significantly better continuity (P ≤ 0.034) in patients who were male, received written information from hospital, were transferred to another hospital before discharge, received follow-up from their general practitioner or had sufficient consultation time after discharge from hospital. CONCLUSION: Risk factors for sub-optimal continuity were identified. These factors are important to patients, healthcare providers and policy makers. Action should be taken to educate patients, reconcile discharge plans and organise post-discharge services. Designing pathways with an interdisciplinary approach and shared responsibility between healthcare settings is recommended. BioMed Central 2020-01-31 /pmc/articles/PMC6993348/ /pubmed/32005235 http://dx.doi.org/10.1186/s12913-020-4908-1 Text en © The Author(s). 2020 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Valaker, Irene Fridlund, Bengt Wentzel-Larsen, Tore Nordrehaug, Jan Erik Rotevatn, Svein Råholm, Maj-Britt Norekvål, Tone M. Continuity of care and its associations with self-reported health, clinical characteristics and follow-up services after percutaneous coronary intervention |
title | Continuity of care and its associations with self-reported health, clinical characteristics and follow-up services after percutaneous coronary intervention |
title_full | Continuity of care and its associations with self-reported health, clinical characteristics and follow-up services after percutaneous coronary intervention |
title_fullStr | Continuity of care and its associations with self-reported health, clinical characteristics and follow-up services after percutaneous coronary intervention |
title_full_unstemmed | Continuity of care and its associations with self-reported health, clinical characteristics and follow-up services after percutaneous coronary intervention |
title_short | Continuity of care and its associations with self-reported health, clinical characteristics and follow-up services after percutaneous coronary intervention |
title_sort | continuity of care and its associations with self-reported health, clinical characteristics and follow-up services after percutaneous coronary intervention |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6993348/ https://www.ncbi.nlm.nih.gov/pubmed/32005235 http://dx.doi.org/10.1186/s12913-020-4908-1 |
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