Associations of care continuity and care coordination with the overuse of healthcare services: a nationwide population-based study.

Background: Care continuity and care coordination have received increased attention as important ways of decreasing overuse/low-value care. Prior research has verified an association between care continuity and overuse or an association between care coordination and overuse. However, little is known about the relative influences of care continuity and care coordination on overuse.

Impact of care coordination on 30-day readmission, mortality, and costs for heart failure.

Objectives: Although coordination of care has become the main focus of health care reform efforts to improve outcomes and decrease costs, limited information is available concerning the impact of care coordination on 30-day outcomes and costs. We used nationwide, population-based data to examine the influence of care coordination on 30-day readmission, mortality, and costs for heart failure (HF).

Study Design: We analyzed 20,713 patients with HF 18 years or older discharged from hospitals in 2016 using Taiwan's National Health Insurance Research Database.

Associations of continuity and coordination of care with outcomes and costs after discharge among patients with heart failure: A nationwide population-based study.

Background: Although continuity and coordination of care have received increased attention as important ways to improve outcomes and decrease costs, limited information is available concerning the effects of "care continuity" and "care coordination" on mortality and costs. We used nationwide population-based data from Taiwan to explore the effects of care continuity and coordination on mortality and costs for heart failure.

Methods: We analyzed all 18,991 heart failure patients 18 years of age or older and discharged from hospitals in 2016 using Taiwan's National Health Insurance claims data.

Association of antidiabetic therapies with lower extremity amputation, mortality and healthcare cost from a nationwide retrospective cohort study in Taiwan.

We compared risks of clinical outcomes, mortality and healthcare costs among new users of different classes of anti-diabetic medications. This is a population-based, retrospective, new-user design cohort study using the Taiwan National Health Insurance Database between May 2, 2015 and September 30, 2017. An individual was assigned to a medication group based on the first anti-diabetic prescription on or after May 1, 2016: SGLT-2 inhibitors, DPP-4 inhibitors, GLP-1 agonists or older agents (metformin, etc.

Impact of bundled payments on hip fracture outcomes: a nationwide population-based study.

Objective: Establishing one price for all bundled services for a particular illness, which has become the key to healthcare reform efforts, is designed to encourage health professionals to coordinate their care for patients. Limited information is available, however, concerning whether bundled payments are associated with changes in patient outcomes. Nationwide longitudinal population-based data were used to examine the effect of bundled payments on hip fracture outcomes.

Relationship between Early Physician Follow-Up and 30-Day Readmission after Acute Myocardial Infarction and Heart Failure.

Background: Thirty-day readmission rates after acute myocardial infarction (AMI) and heart failure are important patient outcome metrics. Early post-discharge physician follow-up has been promoted as a method of reducing 30-day readmission rates. However, the relationships between early post-discharge follow-up and 30-day readmission for AMI and heart failure are inconclusive.

The Relationships Among Regionalization, Processes, and Outcomes for Stroke Care: A Nationwide Population-based Study.

Regionalization for stroke care, including stroke center designation, is being implemented in the United States, Canada, or other countries. Limited information is available, however, concerning the relationships among regionalization, processes, and outcomes for stroke care. We examined the association of regionalization with processes and outcomes, and the mediating effect of processes of care on the association between regionalization and mortality for acute stroke in Taiwan.

The Effect of Anesthetic Type on Outcomes of Hip Fracture Surgery: A Nationwide Population-Based Study.

Hip fractures are a global public health problem. During surgery following hip fractures, both general and regional anesthesia are used, but which type of anesthesia offers a better outcome remains controversial. There has been little research evaluating different anesthetic types on mortality and readmission rates for hip fracture surgery using nationwide population-based data.

Processes and outcomes of ischemic stroke care: the influence of hospital level of care.

Objective: Processes of stroke care play an increasingly important role in comparing hospital performance. The relationship between processes of care and outcomes for stroke is unclear. Moreover, in terms of stroke care regionalization, little information is available with regard to the relationships among hospital level of care, processes and outcomes of stroke care.

Long-term effect of fee-for-service-based reimbursement cuts on processes and outcomes of care for stroke: interrupted time-series study from Taiwan.

Background: As healthcare spending continues to increase, reimbursement cuts have become 1 type of healthcare reform to contain costs. Little is known about the long-term impact of cuts in reimbursement, especially under a global budget cap with fee-for-service (FFS) reimbursement, on processes and outcomes of care. The FFS-based reimbursement cuts have been implemented since July 2002 in Taiwan.

The relationships among physician and hospital volume, processes, and outcomes of care for acute myocardial infarction.

Background: A volume-outcome relationship has been found for acute myocardial infarction (AMI); however, the mechanisms underlying the relationship remain unclear. In particular, it is not known whether processes of care are mediators of the volume-outcome relationship, that is, whether the mechanisms underlying the relationship are through processes of care.

Objective: We used nationwide population-based data to examine the mediating effects of processes of care on the relationships of physician and hospital volume with AMI mortality.

Factors associated with pneumonia outcomes: a nationwide population-based study over the 1997-2008 period.

Background: Pneumonia is the most common infectious cause of death worldwide. Over the last decade, patient characteristics and health care factors have changed. However, little information is available regarding systematically and simultaneously exploring effects of these changes on pneumonia outcomes.

Impact of cuts in reimbursement on outcome of acute myocardial infarction and use of percutaneous coronary intervention: a nationwide population-based study over the period 1997 to 2008.

Background: The impact of cuts in reimbursement, such as the Balanced Budget Act in the United States or global budgeting, on the quality of patient care is an important issue in health-care reform. Limited information is available regarding whether reimbursement cuts are associated with processes and outcomes of acute myocardial infarction (AMI) care.

Objectives: We used nationwide longitudinal population-based data to examine how 30-day mortality and percutaneous coronary intervention (PCI) use for AMI patients changed in accordance with the degree of financial strain induced by the implementation of hospital global budgeting since July 2002 in Taiwan.

The effect of cuts in reimbursement on stroke outcome: a nationwide population-based study during the period 1998 to 2007.

Background And Purpose: As healthcare costs keep rising, cuts in reimbursement such as the Balanced Budget Act in the United States or global budgeting have become the key to healthcare reform efforts. Limited information is available, however, concerning whether reimbursement cuts are associated with changes in stroke outcomes. The objective of this study is to determine whether 30-day mortality rates for patients with ischemic stroke changed under increased financial strain from global budgeting in Taiwan.

Associations of physician volume and weekend admissions with ischemic stroke outcome in Taiwan: a nationwide population-based study.

Background: Although volume-outcome and weekend-outcome relationships have been explored for various procedures and interventions, limited information is available concerning "physician volume" and the "weekend effect" on stroke mortality. Moreover, little is known about the relative and combined influence of physician and hospital volume on stroke mortality.

Objectives: We used nationwide population-based data to explore the influences of physician volume and weekend admissions on stroke mortality.

Patient satisfaction with and recommendation of a primary care provider: associations of perceived quality and patient education.

Objective: To identify whether attributes of perceived clinic quality and patient education are associated with patient satisfaction and recommendation of a primary care provider.

Design: Data used in this study were obtained through a national telephone survey by random sampling.

Setting: Clinics throughout Taiwan.