Why the study?
Care transitions are frequent among patients with dementia, and the impact of continuity of care on successful community discharge after hospitalization needed evaluation.
Does higher continuity of care improve successful community discharge in older veterans with dementia?
Does higher continuity of care improve successful community discharge in older veterans with dementia?
Better continuity of care may have a small impact on improving successful direct community discharge for older veterans with dementia.
Higher continuity of care shows only marginal association with successful discharge; leaves open whether targeted interventions improve outcomes in dementia.
Background Care transitions are frequent among patients with dementia. This study aimed to estimate the impact of continuity of care (COC) on successful community discharge after hospitalization. Methods National Veterans Health Administration data linked to Medicare claims in fiscal years 2014–2015. Community-dwelling older veterans with dementia with an acute hospitalization were included ( n = 31,648). COC was measured by the Bice-Boxerman Continuity of Care (BBC) index (0–1). Association of COC before hospitalization on successful community discharge was examined separately among veterans discharged to the community directly and through post-acute care facilities. Results Veterans with a 0.1 higher BBC were 4.6% ( p = .06) more likely to have successful direct community discharge; but BBC had no demonstrable effect when discharge was through post-acute care facilities. Conclusion Better COC may have impact at improving successful direct community discharge, although the effect is small and the type I error rate (statistical significance) was 6%.
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Lei et al. (2021) studied this question.
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