Continuity of care and hospitalization frequency for ambulatory care-sensitive conditions after hearing-disability onset: a retrospective cohort study

Abstract

We assessed the effect of continuity of care (COC) on the frequency of hospitalization for Ambulatory care-sensitive conditions (ACSCs) to estimate the impact of COC and hearing disability relative to the controls. This retrospective cohort study used claim data of Korean National Health Insurance Service – National Sample Cohort 2.0 DB. We used propensity score matching to determine a control group for the hearing disability group by age, sex, and the Charlson Comorbidity Index. The hearing-impaired group included 720 participants, and the non-disabled control group, consisting of individuals without any form of disability, had 1,423 individuals. We used the frequency of hospitalization for ACSCs during one-year follow-up as the dependent variable for Poisson regression. We measured COC with the Bice–Boxerman Continuity of Care Index (COCI); higher COCI values represent better continuity of care, with COCI values ranging from 0 to 1. Poisson regression showed that disability status modifies the effect of COCI on the incidence of hospitalization. COCI = 1 reduced hospitalizations in people with hearing disabilities (adjusted Incidence Rate Ratio [aIRR]: 0.30, 95% CI: 0.20–0.44) but was not statistically significant for controls. In the COCI = 1 group, the effect of disability was not significant(aIRR: 1.10, 95% CI: 0.83–1.44). Compared to people without disabilities, enhanced COC for people with hearing disabilities was more effective in preventing hospitalizations for ACSCs.