Key result
Hypertensive patients managed under the Loose Collaboration Model were more likely to be familiar with a primary care physician than those under the Direct Management Model.
Why the study?
Does the Loose Collaboration Model improve continuity of care compared to the Direct Management Model in hypertensive patients?
Cross-Sectional (n=782)
Yes
Does the Loose Collaboration Model improve continuity of care compared to the Direct Management Model in hypertensive patients?
The Loose Collaboration Model of primary care delivery was associated with better relational and management continuity of care for hypertensive patients compared to the Direct Management Model.
Answers are grounded in this paper and cite their sources.
Loose Collaboration Model may support continuity in hypertension; leaves open whether it improves outcomes over Direct Management in prospective studies.
BACKGROUND: Policy makers require information regarding performance of different primary care delivery models in managing hypertension, which can be helpful for better hypertension management. This study aims to compare continuity of care among hypertensive patients between Direct Management (DM) Model of community health centers (CHCs) in Wuhan and Loose Collaboration (LC) Model in Nanjing. METHODS: A cross-sectional questionnaire survey was conducted. Four CHCs in each city were randomly selected as study settings. 386 patients in Nanjing and 396 in Wuhan completed face-to-face interview surveys and were included in the final analysis. The relational continuity and coordination continuity (including both information continuity and management continuity) were measured and analyzed. Binary or multinomial logistic regression models were used for comparison between the two cities. RESULTS: Participants from Nanjing had better relational continuity with primary care providers as compared with those from Wuhan, including more likely to be familiar with a CHC physician (OR = 2.762; 95%CI: 1.878 to 4.061), taken care of by the same CHC physician (OR = 1.846; 95%CI: 1.262 to 2.700), and known well by a CHC physician (OR = 1.762; 95%CI: 1.206 to 2.572). Multinomial logistic regression analyses showed there were significant differences between the two cities in reported frequency of communications between hospital and CHC physicians (P = 0.001), whether hospital and CHC physicians gave same treatment suggestions (P = 0.016), as well as how treatment strategy was formulated (P < 0.001). Participants in Wuhan were less likely than those in Nanjing to consider there was continuum regarding health services provided by hospital and CHC physicians (OR = 3.932; 95%CI: 2.394 to 6.459). CONCLUSIONS: Our study shows that continuity of care is better for LC Model in Nanjing than DM Model in Wuhan. Our study suggests there is room for improvement regarding relational and information continuity in both cities.
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Li et al. (2016) conducted a cross-sectional in Hypertension (n=782). Loose Collaboration (LC) Model vs. Direct Management (DM) Model was evaluated on Familiarity with a community health center (CHC) physician (OR 2.762, 95% CI 1.878-4.061, p=<0.001). Hypertensive patients managed under the Loose Collaboration Model were more likely to be familiar with a primary care physician than those under the Direct Management Model.
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