Consistent home-based care reduces urgent care use and hospitalizations in older adults

Background: This study examined whether continuity of care (how often patients see their assigned physician and nurse) was associated with urgent care use and hospital admissions among older adults receiving permanent home-based primary care.

What they found: Researchers analyzed electronic health record data from three primary care centers in Barcelona, Spain, including 1,207 patients receiving permanent home-based care. The average patient age was 88.5 years, and most had multiple chronic conditions. Over one year, mean continuity of care was 73.3% with assigned general practitioners and 83.1% with assigned primary care nurses. Patients who saw their assigned clinician more often were less likely to use home ambulance services. Those patients were also less likely to visit the emergency department, or be admitted to the hospital. Seeing the same general practitioner for at least three out of four visits was associated with about a 39% lower likelihood of emergency department visits over one year, fewer ambulance calls, and fewer hospital admissions. Higher continuity with assigned nurses was also associated with fewer ambulance calls and fewer hospital admissions.

Implications: These findings support efforts to keep care relationships stable, particularly aiming for at least 75% of general practitioner visits with the assigned general practitioner.