Effect of Continuity of Care on Satisfaction in Adult Patients with Hypertension: A Cohort Study in China

Abstract

Background : Continuity of care (COC) is considered a principle of primary care and is widely believed to reduce healthcare utilization and mortality. Yet, little is known about the association between COC and patients’ satisfaction in China. Objective : To assess the effect of COC on satisfaction in adult patients with hypertension in China. Design : A cohort study was carried out in six towns of the Qianjiang District, Chongqing from July 2012 to June 2014. Claim-based longitudinal data from hypertension follow-up services records were used to calculate the continuity of care index (COCI). Survey-based self-reported data were used to assess patients’ satisfaction and to estimate the propensity score. A total of 1079 hypertensive patients aged 35 years and older were selected as a study sample. Methods : Hypertensive patients were categorized into two groups according to COCI. The group with poor continuity served as the control and then matched to the high continuity group using the propensity score. The average treatment effect on the treated (ATT) was estimated. Results : There were no statistically difference between high COC group and low COC group on satisfaction. Conclusion : After eliminating the selection bias and reversing causality, continuity of hypertension care may not improve hypertensive patients’ satisfaction.