The association between continuity of care and surgery in lumbar disc herniation patients

Abstract Continuity of care is a core dimension of high-quality care in the management of disease. The purpose of this study was to investigate the association between continuity of care and lumbar surgery in patients with moderate disc herniation. The Korean National Sample Cohort was used. The tar...

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Autores principales:	Eun-San Kim, Chang-yup Kim
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/9e3ceb3c8fbd4c5ba72db59b0a98a784
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spelling	oai:doaj.org-article:9e3ceb3c8fbd4c5ba72db59b0a98a7842021-12-02T13:20:22ZThe association between continuity of care and surgery in lumbar disc herniation patients10.1038/s41598-021-85064-12045-2322https://doaj.org/article/9e3ceb3c8fbd4c5ba72db59b0a98a7842021-03-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-85064-1https://doaj.org/toc/2045-2322Abstract Continuity of care is a core dimension of high-quality care in the management of disease. The purpose of this study was to investigate the association between continuity of care and lumbar surgery in patients with moderate disc herniation. The Korean National Sample Cohort was used. The target population consisted of patients who have had disc herniation more than 6 months and didn’t get surgery and red flag signs within 6 months from onset. The population was enrolled from 2004 to 2013. The Bice-Boxerman Continuity of Care was used in measuring continuity of care. The marginal structural model with time dependent survival analysis was used. In total, 29,061 patients were enrolled in the cohort. High level of continuity of care was associated with a lower risk of lumbar surgery (HR, 0.27; 95% CI, 0.20–0.27). When the index was calculated only with outpatient visits to primary care with related specialty, the HR was 0.49 (95% CI: 0.43–0.57). In exploratory analysis, patients with lumbar stenosis and spondylolisthesis had higher risk of having a low level of continuity of care. These results indicate that continuity of care is associated with lower rates of lumbar surgery in patients with moderate disc herniation.Eun-San KimChang-yup KimNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Eun-San Kim Chang-yup Kim The association between continuity of care and surgery in lumbar disc herniation patients
description	Abstract Continuity of care is a core dimension of high-quality care in the management of disease. The purpose of this study was to investigate the association between continuity of care and lumbar surgery in patients with moderate disc herniation. The Korean National Sample Cohort was used. The target population consisted of patients who have had disc herniation more than 6 months and didn’t get surgery and red flag signs within 6 months from onset. The population was enrolled from 2004 to 2013. The Bice-Boxerman Continuity of Care was used in measuring continuity of care. The marginal structural model with time dependent survival analysis was used. In total, 29,061 patients were enrolled in the cohort. High level of continuity of care was associated with a lower risk of lumbar surgery (HR, 0.27; 95% CI, 0.20–0.27). When the index was calculated only with outpatient visits to primary care with related specialty, the HR was 0.49 (95% CI: 0.43–0.57). In exploratory analysis, patients with lumbar stenosis and spondylolisthesis had higher risk of having a low level of continuity of care. These results indicate that continuity of care is associated with lower rates of lumbar surgery in patients with moderate disc herniation.
format	article
author	Eun-San Kim Chang-yup Kim
author_facet	Eun-San Kim Chang-yup Kim
author_sort	Eun-San Kim
title	The association between continuity of care and surgery in lumbar disc herniation patients
title_short	The association between continuity of care and surgery in lumbar disc herniation patients
title_full	The association between continuity of care and surgery in lumbar disc herniation patients
title_fullStr	The association between continuity of care and surgery in lumbar disc herniation patients
title_full_unstemmed	The association between continuity of care and surgery in lumbar disc herniation patients
title_sort	association between continuity of care and surgery in lumbar disc herniation patients
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/9e3ceb3c8fbd4c5ba72db59b0a98a784
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The association between continuity of care and surgery in lumbar disc herniation patients

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