This report uses the results from the Coordination of Health Care (CHC) study to examine aspects of continuity of care in patients aged 45 years and over. In particular, we look at what patient characteristics and care coordination measures are associated with potentially preventable hospitalisations (PPH), with a specific focus on PPH related to chronic conditions (CC-PPH).
The CHC study was developed by the Australian Institute of Health and Welfare (AIHW) in partnership with the Australian Bureau of Statistics (ABS) to fill an important data gap relating to continuity of care. The CHC study provided self-reported information on patients’ experiences of coordination and continuity of care across Australia.
Those most likely to have a CC-PPH in the study period were:
- People in older age groups
- Individuals with worse self-rated health
- Individuals with an increased number of different types of medication taken on a regular or ongoing basis
- Individuals who spoke English as their main language at home
- Individuals who reported that they were frequent users of GP services
The characteristics associated with having CC-PPH are also associated with other types of hospitalisations, but there is evidence that CC-PPH may be more strongly associated with some of these factors than hospitalisations more generally. For example, older age, poorer health and polypharmacy were particularly more strongly associated with CC-PPH than other hospitalisations, likely due to the stronger association between chronic conditions and these attributes.
While no continuity of care measures emerged as significantly associated with CC-PPH in this analysis, one measure of access to health care did. People who did not see a GP when they needed to were more likely to have a CC-PPH, and the effect was specific to this type of hospitalisation.
The findings of this study broadly support the idea that the PPH concept captures health service needs (primary and hospital), regardless of how or why that need has arisen. This is consistent with other studies, which also find that the health of individuals is the most important factor driving PPH admissions, but they also point to the importance of access to GPs in chronic condition management.