TY - JOUR
AU - N. M. P. Nguyen
AU - B. J. Borah
AU - M. Barr
AU - B. Harris-Roxas
AU - A. Sharma
A1 - 
AB - PURPOSE: Reducing potentially preventable hospitalization (PPH), also known as ambulatory care-senstive conditions, is a global concern. This study linked data from Sax Institute's 45 and Up Study on individuals aged 45 years and older from New South Wales, Australia, with Australian Medicare claims data to establish a causal relationship between continuity of care and acute PPH using a double machine learning model. METHODS: We utilized 11 years of linked data (2007-2017) to analyze the impact of continuity of care on acute PPH, controlling for key patient characteristics (ie, age, multimorbidity status, cultural diversity, sex, education level, psychological status, physical limitation, smoking status, socioeconomic deciles). Estimation was done using a double machine learning technique with 4 algorithms (ie, least absolute shrinkage and selection operator, random forest, extreme gradient boosting, artificial neural network) to ensure robustness. RESULTS: Among 54,376 participants, 27,634 individuals (50.8%) experienced at least 1 acute PPH episode during the 11-year study period. Our findings indicate that even a slight improvement in continuity of care can reduce the incidence of acute PPH compared with non-acute PPH. For example, the reduction in the probability of acute PPH compared with non-acute PPH ranges from 9.8% (95% CI, 1.1%-17.8%) to 23.5% (95% CI, 14.1%-32.4%) across 4 models when continuity of care increases from the 45th percentile (0.274) to the 50th percentile (0.301). CONCLUSION: Continuity of care at the primary level plays a key role in reducing acute PPH. Policies focused on person-centered or integrated care should include initiatives to promote continuity of care and support general practitioners in improving continuity of care.The authors of this article have provided Hindi and Vietnamese translations of the abstract.
AD - School of Population Health, University of New South Wales, Sydney, New South Wales, Australia.; Mayo Clinic College of Medicine & Science, Rochester, Minnesota.; International Centre for Future Health Systems, University of New South Wales, Sydney, New South Wales, Australia.; School of Population Health, University of New South Wales, Sydney, New South Wales, Australia anurag.sharma@unsw.edu.au.
AN - 41285609
BT - Ann Fam Med
C5 - HIT & Telehealth
CP - 6
DA - Nov 24
DO - 10.1370/afm.240569
DP - NLM
ET - 20251124
IS - 6
JF - Ann Fam Med
LA - eng
N2 - PURPOSE: Reducing potentially preventable hospitalization (PPH), also known as ambulatory care-senstive conditions, is a global concern. This study linked data from Sax Institute's 45 and Up Study on individuals aged 45 years and older from New South Wales, Australia, with Australian Medicare claims data to establish a causal relationship between continuity of care and acute PPH using a double machine learning model. METHODS: We utilized 11 years of linked data (2007-2017) to analyze the impact of continuity of care on acute PPH, controlling for key patient characteristics (ie, age, multimorbidity status, cultural diversity, sex, education level, psychological status, physical limitation, smoking status, socioeconomic deciles). Estimation was done using a double machine learning technique with 4 algorithms (ie, least absolute shrinkage and selection operator, random forest, extreme gradient boosting, artificial neural network) to ensure robustness. RESULTS: Among 54,376 participants, 27,634 individuals (50.8%) experienced at least 1 acute PPH episode during the 11-year study period. Our findings indicate that even a slight improvement in continuity of care can reduce the incidence of acute PPH compared with non-acute PPH. For example, the reduction in the probability of acute PPH compared with non-acute PPH ranges from 9.8% (95% CI, 1.1%-17.8%) to 23.5% (95% CI, 14.1%-32.4%) across 4 models when continuity of care increases from the 45th percentile (0.274) to the 50th percentile (0.301). CONCLUSION: Continuity of care at the primary level plays a key role in reducing acute PPH. Policies focused on person-centered or integrated care should include initiatives to promote continuity of care and support general practitioners in improving continuity of care.The authors of this article have provided Hindi and Vietnamese translations of the abstract.
PY - 2025
SN - 1544-1709 (Print); 1544-1709
SP - 515
EP - 523+
ST - Continuity of Primary Care and Preventable Hospitalization for Acute Conditions: A Machine Learning-Based Record Linkage Study
T1 - Continuity of Primary Care and Preventable Hospitalization for Acute Conditions: A Machine Learning-Based Record Linkage Study
T2 - Ann Fam Med
TI - Continuity of Primary Care and Preventable Hospitalization for Acute Conditions: A Machine Learning-Based Record Linkage Study
U1 - HIT & Telehealth
U3 - 10.1370/afm.240569
VL - 23
VO - 1544-1709 (Print); 1544-1709
Y1 - 2025
ER -