Impact of team-based community healthcare on preventable hospitalisation: a population-based cohort study in Taiwan

Objectives The objective of this study was to explore the impact of Taiwan’s Family Practice Integrated Care Project (FPICP) on hospitalisation.Design A population-based cohort study compared the hospitalisation rates for ambulatory care sensitive conditions (ACSCs) among FPICP participating and non...

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Autores principales:	Hsiao-Yu Yang, Tzeng-Ji Chen, Chyi-Feng Jeff Jan, Che-Jui Jerry Chang, Shinn-Jang Hwang, Yu-Chun Chen, Cheng-Kuo Huang, Tai-Yuan Chiu
Formato:	article
Lenguaje:	EN
Publicado:	BMJ Publishing Group 2021
Materias:	Medicine R
Acceso en línea:	https://doaj.org/article/349e9dce66314032a8a942a4e5c36653
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spelling	oai:doaj.org-article:349e9dce66314032a8a942a4e5c366532021-11-19T11:00:06ZImpact of team-based community healthcare on preventable hospitalisation: a population-based cohort study in Taiwan10.1136/bmjopen-2020-0399862044-6055https://doaj.org/article/349e9dce66314032a8a942a4e5c366532021-02-01T00:00:00Zhttps://bmjopen.bmj.com/content/11/2/e039986.fullhttps://doaj.org/toc/2044-6055Objectives The objective of this study was to explore the impact of Taiwan’s Family Practice Integrated Care Project (FPICP) on hospitalisation.Design A population-based cohort study compared the hospitalisation rates for ambulatory care sensitive conditions (ACSCs) among FPICP participating and non-participating patients during 2011–2015.Setting The study accessed the FPICP reimbursement database of Taiwan’s National Health Insurance (NHI) administration containing all NHI administration-selected patients for FPICP enrolment.Participants The NHI administration-selected candidates from 2011 to 2015 became FPICP participants if their primary care physicians joined the project, otherwise they became non-participants.Interventions The intervention of interest was enrolment in the FPICP or not. The follow-up time interval for calculating the rate of hospitalisation was the year in which the patient was selected for FPICP enrolment or not.Primary outcome measures The study’s primary outcome measures were hospitalisation rates for ACSC, including asthma/chronic obstructive pulmonary disease (COPD), diabetes or its complications and heart failure. Logistic regression was used to calculate the ORs concerning the influence of FPICP participation on the rate of hospitalisation for ACSC.Results The enrolled population for data analysis was between 3.94 and 5.34 million from 2011 to 2015. Compared to non-participants, FPICP participants had lower hospitalisation for COPD/asthma (28.6‰–35.9‰ vs 37.9‰–42.3‰) and for diabetes or its complications (10.8‰–14.9‰ vs 12.7‰–18.1‰) but not for congestive heart failure. After adjusting for age, sex and level of comorbidities by logistic regression, participation in the FPICP was associated with lower hospitalisation for COPD/asthma (OR 0.91, 95% CI 0.87 to 0.94 in 2015) and for diabetes or its complications (OR 0.87, 95% CI 0.83 to 0.92 in 2015).Conclusion Participation in the FPICP is an independent protective factor for preventable ACSC hospitalisation. Team-based community healthcare programs such as the FPICP can strengthen primary healthcare capacity.Hsiao-Yu YangTzeng-Ji ChenChyi-Feng Jeff JanChe-Jui Jerry ChangShinn-Jang HwangYu-Chun ChenCheng-Kuo HuangTai-Yuan ChiuBMJ Publishing GrouparticleMedicineRENBMJ Open, Vol 11, Iss 2 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R
spellingShingle	Medicine R Hsiao-Yu Yang Tzeng-Ji Chen Chyi-Feng Jeff Jan Che-Jui Jerry Chang Shinn-Jang Hwang Yu-Chun Chen Cheng-Kuo Huang Tai-Yuan Chiu Impact of team-based community healthcare on preventable hospitalisation: a population-based cohort study in Taiwan
description	Objectives The objective of this study was to explore the impact of Taiwan’s Family Practice Integrated Care Project (FPICP) on hospitalisation.Design A population-based cohort study compared the hospitalisation rates for ambulatory care sensitive conditions (ACSCs) among FPICP participating and non-participating patients during 2011–2015.Setting The study accessed the FPICP reimbursement database of Taiwan’s National Health Insurance (NHI) administration containing all NHI administration-selected patients for FPICP enrolment.Participants The NHI administration-selected candidates from 2011 to 2015 became FPICP participants if their primary care physicians joined the project, otherwise they became non-participants.Interventions The intervention of interest was enrolment in the FPICP or not. The follow-up time interval for calculating the rate of hospitalisation was the year in which the patient was selected for FPICP enrolment or not.Primary outcome measures The study’s primary outcome measures were hospitalisation rates for ACSC, including asthma/chronic obstructive pulmonary disease (COPD), diabetes or its complications and heart failure. Logistic regression was used to calculate the ORs concerning the influence of FPICP participation on the rate of hospitalisation for ACSC.Results The enrolled population for data analysis was between 3.94 and 5.34 million from 2011 to 2015. Compared to non-participants, FPICP participants had lower hospitalisation for COPD/asthma (28.6‰–35.9‰ vs 37.9‰–42.3‰) and for diabetes or its complications (10.8‰–14.9‰ vs 12.7‰–18.1‰) but not for congestive heart failure. After adjusting for age, sex and level of comorbidities by logistic regression, participation in the FPICP was associated with lower hospitalisation for COPD/asthma (OR 0.91, 95% CI 0.87 to 0.94 in 2015) and for diabetes or its complications (OR 0.87, 95% CI 0.83 to 0.92 in 2015).Conclusion Participation in the FPICP is an independent protective factor for preventable ACSC hospitalisation. Team-based community healthcare programs such as the FPICP can strengthen primary healthcare capacity.
format	article
author	Hsiao-Yu Yang Tzeng-Ji Chen Chyi-Feng Jeff Jan Che-Jui Jerry Chang Shinn-Jang Hwang Yu-Chun Chen Cheng-Kuo Huang Tai-Yuan Chiu
author_facet	Hsiao-Yu Yang Tzeng-Ji Chen Chyi-Feng Jeff Jan Che-Jui Jerry Chang Shinn-Jang Hwang Yu-Chun Chen Cheng-Kuo Huang Tai-Yuan Chiu
author_sort	Hsiao-Yu Yang
title	Impact of team-based community healthcare on preventable hospitalisation: a population-based cohort study in Taiwan
title_short	Impact of team-based community healthcare on preventable hospitalisation: a population-based cohort study in Taiwan
title_full	Impact of team-based community healthcare on preventable hospitalisation: a population-based cohort study in Taiwan
title_fullStr	Impact of team-based community healthcare on preventable hospitalisation: a population-based cohort study in Taiwan
title_full_unstemmed	Impact of team-based community healthcare on preventable hospitalisation: a population-based cohort study in Taiwan
title_sort	impact of team-based community healthcare on preventable hospitalisation: a population-based cohort study in taiwan
publisher	BMJ Publishing Group
publishDate	2021
url	https://doaj.org/article/349e9dce66314032a8a942a4e5c36653
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Impact of team-based community healthcare on preventable hospitalisation: a population-based cohort study in Taiwan

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