Ambulatory Care Fragmentation, Emergency Department Visits, and Race: a Nationwide Cohort Study in the U.S.

ABSTRACT:

Background

It is unclear whether highly fragmented ambulatory care (i.e., care spread across multiple providers without a dominant provider) increases the risk of an emergency department (ED) visit. Whether any such association varies with race is unknown.

Objective

We sought to determine whether highly fragmented ambulatory care increases the risk of an ED visit, overall and by race.

Design and participants

We analyzed data for 14,361 participants ≥ 65 years old from the nationwide prospective REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort study, linked to Medicare claims (2003-2016).

Main measures

We defined high fragmentation as a reversed Bice-Boxerman Index ≥ 0.85 (≥ 75^th percentile). We used Poisson models to determine

SUBMITTER: Kern LM 

PROVIDER: S-EPMC10039160 | biostudies-literature | 2023 Mar

REPOSITORIES: biostudies-literature