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. 2021 Feb 18;11(1):4077.
doi: 10.1038/s41598-021-83596-0.

The effect of continuity of care on medical costs in patients with chronic shoulder pain

Ju-Hyun Oh  1 , Boyoung Jung  2   3 , Eun-San Kim  2 , Namkwen Kim  4 , In-Hyuk Ha  5
Affiliations

The effect of continuity of care on medical costs in patients with chronic shoulder pain

Ju-Hyun Oh et al. Sci Rep. .

Abstract

Unnecessary surgery could be prevented through continuity of care (COC). The present study aimed to investigate the relationships between COC, surgery and cost associated with chronic shoulder pain. We used the Health Insurance Review and Assessment Service national patient sample (HIRA-NPS) in 2017. A total of 1717 patients were included. Bice-Boxerman Continuity of Care Index was used as the indicator for measuring the COC. Occurrence of surgery, associated costs, and direct medical costs were analysed. Logistic regression, a two-part model with recycled predictions and generalized linear model with gamma distribution were used. The majority of patients were 40-65 years old (high COC: 68.4%; low COC: 64.4%). The odds ratio (OR) for surgery was 0.41 in the high-COC group compared to the low COC group (95% CI, 0.20 to 0.84). Direct medical cost was 14.09% (95% CI, 8.12% to 19.66%) and 58.00% lower in surgery cost (95% CI, 57.95 to 58.05) in the high-COC group. Interaction with COC and shoulder impingement syndrome was significant lower in direct medical cost (15.05% [95% CI, 1.81% to 26.51%]). High COC was associated with low medical cost in patients diagnosed with chronic shoulder pain.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Flowchart of study population. COC: Continuity of Care Index. Values are presented as numbers (percentages) unless otherwise indicated.
Figure 2
Figure 2
Distribution of COC. COC: Continuity of Care Index. The median of COC distribution was used for criteria.
Figure 3
Figure 3
The distribution of total medical costs. COC: Continuity of Care Index. The medical costs are calculated in United States dollar (20170631).
Figure 4
Figure 4
The distribution of surgery costs. COC: Continuity of Care Index. Surgery costs are calculated only for patients who underwent shoulder surgery (n = 41). The medical costs are calculated in United States dollars (20170631).
See this image and copyright information in PMC

References

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