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The Association between Continuity of Care and All-Cause Mortality in Patients with Newly Diagnosed Obstructive Pulmonary Disease: A Population-Based Retrospective Cohort Study, 2005-2012

 Kyoung Hee Cho  ;  Young Sam Kim  ;  Chung Mo Nam  ;  Tae Hyun Kim  ;  Sun Jung Kim  ;  Kyu-Tae Han  ;  Eun-Cheol Park 
 PLOS ONE, Vol.10(11) : e0141465, 2015 
Journal Title
Issue Date
Chronic Disease ; Continuity of Patient Care* ; Female ; Humans ; Male ; Pulmonary Disease, Chronic Obstructive/diagnosis* ; Pulmonary Disease, Chronic Obstructive/mortality* ; Pulmonary Disease, Chronic Obstructive/therapy* ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Time Factors
BACKGROUND: The disease burden is increasing for chronic obstructive pulmonary disease (COPD) due to increasing of the growth rate of prevalence and mortality. But the empirical researches are a little for COPD that studied the association between continuity of care and death and about predictors effect on mortality. OBJECTIVE: To investigate the association between continuity of care (COC) and chronic obstructive pulmonary disease (COPD) mortality and to identify other mortality-related factors in COPD patients. METHODS: We conducted a longitudinal, population-based retrospective cohort study in adult patients with COPD from 2002 to 2012 using a nationwide health insurance claims database. The study sample included individuals aged 40 years and over who developed COPD in 2005 and survived until 2006. We performed a Cox proportional hazard regression analysis with COC analyzed as a time-dependent covariate. RESULTS: Of the 3,090 participants, 60.8% died before the end of study (N = 1,879). The median years of survival for individuals with high COC (COC index≥0.75) was 3.92, and that for patients with low COC (COC index<0.75) was 2.58 in a Kaplan Meier analysis. In a multivariate, time-dependent analysis, low COC was associated with a 22% increased risk of all-cause mortality (HR, 1.22; 95% CI, 1.09-1.36). Not receiving oxygen therapy at home was associated with a 23% increased risk of all-cause mortality (HR, 1.23; 95% CI, 1.01-1.49). Moreover, the risk of all-cause mortality for individuals who admitted one time increased 38% (HR, 1.38; 95% CI, 1.21-1.59), two times was 63% (HR, 1.63; 95% CI, 1.34-1.99) and 3+ times was 96% (HR, 1.96; 95% CI, 1.63-2.36) relative to the reference group (no admission). CONCLUSIONS: High COC was associated with a decreased risk of all-cause mortality. In addition, home oxygen therapy and number of hospital admissions may predict mortality in patients with COPD.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Young Sam(김영삼) ORCID logo https://orcid.org/0000-0001-9656-8482
Kim, Tae Hyun(김태현) ORCID logo https://orcid.org/0000-0003-1053-8958
Nam, Chung Mo(남정모) ORCID logo https://orcid.org/0000-0003-0985-0928
Park, Eun-Cheol(박은철) ORCID logo https://orcid.org/0000-0002-2306-5398
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