From: Impact of relational continuity of primary care in aged care: a systematic review
Author, Year | N | Outcome Measure | Continuity comparison | Hospitalisation | Emergency Department Presentations | ||||
---|---|---|---|---|---|---|---|---|---|
Point Estimate | 95% CI | P -value | Point Estimate | 95% CI | P -value | ||||
Home care | |||||||||
Jones, 2020 [56] | 178,686 | HR 1st admission/visit | High vs. low | 0.94 | 0.92–0.96 | NR | 0.90 | 0.89–0.92 | NR |
Medium vs. low | 0.96 | 0.94–0.98 | NR | 0.96 | 0.94–0.98 | NR | |||
McGregor, 2018 [55] | 246 | Adjusted IRR admission/visit a | Pre-post HBPC | 0.99 | 0.76–1.27 | NR | 0.91 | 0.72–1.15 | NR |
Continuing Care Retirement Community | |||||||||
Bynum, 2011 [54] | 2,468 | IRR, all admissions b | 24/7 physicians & NPs on-site vs limited on-site GP | 0.55b | NA | < 0.05 | 0.36b | NR | < 0.001c |
IRR, medical admissions b | 0.41b | NA | 0.002c | ||||||
IRR, surgical admissions b | 0.77b | NA | 0.173c | ||||||
Residential care | |||||||||
Haines, 2020 [53] | NR (15 sites) | IRR, unplanned – Primary ITT analysis d | In house GP + changed nurse roles e vs Aust standard (“continuity model”) | 0.74 | 0.56–0.96 | 0.024f | 0.81g | 0.66–1.01 | 0.06f |
IRR, unplanned – contamination adjusted d | 0.52 | 0.41–0.64 | < 0.001 | 0.53 | 0.43–0.66 | < 0.001 | |||
Length of hospital stay- IRR, Primary ITT analysis d | 0.87 | 0.79–0.97 | 0.007f | NA | NA | NA | |||
Length of hospital stay- IRR, contamination adjusted d | 0.44 | 0.30–0.63 | < 0.001 | ||||||
Susman, 1989 [57] | 335 | Mean length of stay (days) | 0 Physician visits | 9.6 days | NR | < 0.005h | NA | NA | NA |
1 Physician visits | 11.4 days | ||||||||
2 Physician visits | 11.8 days | ||||||||
≥ 3 Physician visits | 13.1 day |