Continuity of Care and Coordination of Care: Can they Be Differentiated?

Chi-Chen Chen; Yi-Chen Chiang; Yi-Chieh Lin; Shou-Hsia Cheng

doi:10.5334/ijic.6467

Continuity of Care and Coordination of Care: Can they Be Differentiated?

Int J Integr Care. 2023 Feb 17;23(1):10. doi: 10.5334/ijic.6467. eCollection 2023 Jan-Mar.

Authors

Chi-Chen Chen¹, Yi-Chen Chiang², Yi-Chieh Lin³, Shou-Hsia Cheng⁴

Affiliations

¹ Department of Public Health, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan.
² School of Public Health, Xiamen University, Xiamen, China.
³ Department of Public health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung City, Taiwan.
⁴ Institute of Health Policy & Management, College of Public Health and Population Health Research Center, National Taiwan University, Taipei, Taiwan.

Abstract

Introduction: Both care continuity and coordination are considered essential elements of health care system. However, little is known about the relationship between care continuity and coordination. This study aimed to differentiate the concepts of care continuity and coordination by developing and testing the reliability and validity of the Combined Outpatient Care Continuity and Coordination Assessment (COCCCA) questionnaire under the universal coverage health care system in Taiwan from a patient perspective.

Methods: Face-to-face interviews were conducted nationwide with community-dwelling older adults selected via stratified multistage systematic sampling with probability-proportional-to-size process. A total of 2,144 subjects completed the questionnaire, with a response rate of 44.67%.

Results: The 16 items of the COCCCA questionnaire were identified via item analysis and principal component analysis (PCA). The PCA generated five dimensions: three continuity-oriented (interpersonal, information sharing and longitudinal between patients and physicians) and two coordination-oriented (information exchange and communication/cooperation among multiple physicians). The second-order confirmatory factor analysis supported the factor structure and indicated that distinct constructs of care continuity and coordination can be identified.

Conclusion: The COCCCA instrument can differentiate the concepts of care continuity and care coordination and has been demonstrated to be valid and reliable in outpatient care settings from a patient perspective.

Keywords: care continuity; care coordination; outpatient setting; psychometric analysis; questionnaire.

Grants and funding

The study was supported by grants from the Ministry of Science and Technology (MOST 103-2410-H-002-202-MY3; MOST 108-2410-H-030 -083 -SS3) and the National Health Research Institutes (NHRI-EX111-11001PI) in Taiwan. The funding source had no role in the study.