Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/30009
Full metadata record
DC FieldValueLanguage
dc.contributor.authorUng, David-
dc.contributor.authorWang, Yun-
dc.contributor.authorSundararajan, Vijaya-
dc.contributor.authorLopez, Derrick-
dc.contributor.authorKilkenny, Monique F-
dc.contributor.authorCadilhac, Dominique A-
dc.contributor.authorThrift, Amanda G-
dc.contributor.authorNelson, Mark R-
dc.contributor.authorAndrew, Nadine E-
dc.date2021-12-22-
dc.date.accessioned2022-06-22T06:47:44Z-
dc.date.available2022-06-22T06:47:44Z-
dc.date.issued2022-
dc.identifier.citationNeuroepidemiology 2022; 56(2): 90-96en
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/30009-
dc.description.abstractPrimary care physicians (PCPs) provide ongoing management after stroke. However, little is known about how best to measure physician encounters with reference to longer term outcomes. We aimed to compare methods for measuring regularity and continuity of PCP encounters, based on survival following stroke using linked healthcare data. Data from the Australian Stroke Clinical Registry (2010-2014) were linked with Australian Medicare claims from 2009 to 2016. Physician encounters were ascertained within 18 months of discharge for stroke. We calculated three separate measures of continuity of encounters (consistency of visits with primary physician) and three for regularity of encounters (distribution of service utilization over time). Indices were compared based on 1-year survival using multivariable Cox regression models. The best performing measures of regularity and continuity, based on model fit, were combined into a composite "optimal care" variable. Among 10,728 registrants (43% female, 69% aged ≥65 years), the median number of encounters was 17. The measures most associated with survival (hazard ratio [95% confidence interval], Akaike information criterion [AIC], and Bayesian information criterion [BIC]) were the Continuity of Care Index (COCI, as a measure of continuity; 0.88 [0.76-1.02], p = 0.099, AIC = 13,746, BIC = 13,855) and our persistence measure of regularity (encounter at least every 6 months; 0.80 [0.67-0.95], p = 0.011, AIC = 13,742, BIC = 13,852). Our composite measure, persistent plus COCI ≥80% (24% of registrants; 0.80 [0.68-0.94], p = 0.008, AIC = 13,742, BIC = 13,851), performed marginally better than our persistence measure alone. Our persistence measure of regularity or composite measure may be useful when measuring physician encounters following stroke.en
dc.language.isoeng
dc.subjectContinuity of careen
dc.subjectPrimary care physicianen
dc.subjectRegularityen
dc.subjectStrokeen
dc.subjectSurvivalen
dc.titleOptimal Measures for Primary Care Physician Encounters after Stroke and Association with Survival: A Data Linkage Study.en
dc.typeJournal Articleen
dc.identifier.journaltitleNeuroepidemiologyen
dc.identifier.affiliationThe Florey Institute of Neuroscience and Mental Healthen
dc.identifier.affiliationStroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australiaen
dc.identifier.affiliationPeninsula Clinical School, Central Clinical School, Monash University, Frankston, Victoria, Australiaen
dc.identifier.affiliationDepartment of Public Health, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australiaen
dc.identifier.affiliationSchool of Pharmacy, Chapman University, Irvine, California, USAen
dc.identifier.affiliationDepartment of Epidemiology and Preventative Medicine, Monash University, Melbourne, Victoria, Australiaen
dc.identifier.affiliationMenzies Institute for Medical Research, Hobart, Tasmania, Australiaen
dc.identifier.affiliationSchool of Population and Global Health, The University of Western Australia, Perth, Washington, Australiaen
dc.identifier.pubmedurihttps://pubmed.ncbi.nlm.nih.gov/34937038/en
dc.identifier.doi10.1159/000520700en
dc.type.contentTexten
dc.identifier.orcid0000-0002-3375-287Xen
dc.identifier.orcid0000-0001-8162-682Xen
dc.identifier.pubmedid34937038
item.languageiso639-1en-
item.fulltextNo Fulltext-
item.grantfulltextnone-
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.cerifentitytypePublications-
item.openairetypeJournal Article-
Appears in Collections:Journal articles
Show simple item record

Page view(s)

22
checked on Dec 24, 2024

Google ScholarTM

Check


Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.