Fragmented VA Home-Based Primary Care linked to more ED visits
Consolidating fragmented Veterans Affairs (VA) Home-Based Primary Care (HBPC) could reduce preventable acute care, according to a study that found fragmented care was associated with more ED visits.
In this retrospective cohort study, 8908 HBPC patients who were enrolled in the VA and Medicare, whose risk of hospitalization or death was in the top 10%, and who had at least 4 outpatient visits between October 1, 2013, and September 30, 2014 were included. Patients had a mean (SD) of 11.25 (3.87) chronic conditions, including disabling conditions such as dementia (38.8% [n = 3457]).
The researchers found that having more practitioners was associated with increased odds of an ED visit and hospitalization for an ambulatory care sensitive conditions (ACSC). More concentrated care with a higher Usual Provider Continuity Index was associated with reduced odds for ED visits and ACSC hospitalizations.
Edwards ST, Greene L, Chaudhary C, et al. Outpatient Care Fragmentation and Acute Care Utilization in Veterans Affairs Home-Based Primary Care. JAMA Netw Open. 2022;5(9):e2230036. doi: 10.1001/jamanetworkopen.2022.30036. PMID: 36066895.