Background
Methods
Translation and adaption
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Personal continuity: care provider knows me (5 items each for general practitioner in primary care setting and specialist in hospital).
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Personal continuity: care provider shows commitment (3 items each for general practitioner in primary care setting and specialist in hospital).
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Team/cross-boundary continuity (4 items each for collaboration between care providers within primary care setting, within the hospital/outpatient department and between the primary and hospital care providers).
Participants and data collection
Statistical analysis
Reliability
Validity
Influencing factors of COC
Results
Demographic and clinical characteristics of participants
Characteristics | Number | Percent | Mean (SD)/Median(Q1-Q2) | Minimum-Maximum |
---|---|---|---|---|
Age | 61.7 (12.3) | 18–86 | ||
Gender | ||||
Male | 191 | 42.6 | ||
Female | 257 | 57.4 | ||
Marital status | ||||
Married | 420 | 93.8 | ||
Other | 28 | 6.3 | ||
Income | ||||
≤4000 | 157 | 35.0 | ||
4001–6000 | 224 | 50.0 | ||
> 6000 | 67 | 15.0 | ||
Education level | ||||
Senior high school or lower | 332 | 74.1 | ||
College or higher | 116 | 25.9 | ||
Employment | ||||
Employed | 110 | 27.2 | ||
Unemployed | 326 | 72.8 | ||
BMI | 25.61 ± 3.70 | 16.16–25.61 | ||
Charlson Index | 2 (1–3) | 0–11 | ||
Duration of hypertension | 5 (3–12) | 1–45 | ||
Blood Pressure Level | ||||
Normal | 237 | 52.9 | ||
Abnormal | 211 | 47.1 | ||
Blood Pressure Pattern | ||||
Normal | 114 | 25.4 | ||
Abnormal | 334 | 74.6 | ||
Physical Activity | 34.75 ± 9.52 | 14–42 | ||
Mental Function | 39.53 ± 14.97 | 10–68 | ||
General Health Perception | 73.56 ± 11.17 | 30–90 | ||
Medical insurance | ||||
Yes | 338 | 75.0 | ||
No | 110 | 25.0 | ||
The frequency of family visit | ||||
Less than 4 times per year | 248 | 55.4 | ||
More | 200 | 44.6 |
Reliability
Validity
Item | Experts’ rating | Number of Three or Four Items | I-CVI | Evaluation | ||||||
---|---|---|---|---|---|---|---|---|---|---|
A | B | C | D | E | F | G | ||||
1 | 4 | 4 | 3 | 4 | 2 | 4 | 4 | 6 | 0.86 | Excellent |
2 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 7 | 1 | Excellent |
3 | 4 | 3 | 4 | 3 | 4 | 4 | 4 | 7 | 1 | Excellent |
4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 7 | 1 | Excellent |
5 | 4 | 3 | 4 | 2 | 2 | 4 | 4 | 5 | 0.71 | Good |
6 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 7 | 1 | Excellent |
7 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 7 | 1 | Excellent |
8 | 4 | 4 | 4 | 4 | 3 | 4 | 4 | 7 | 1 | Excellent |
9 | 4 | 4 | 4 | 4 | 3 | 4 | 4 | 7 | 1 | Excellent |
10 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 7 | 1 | Excellent |
11 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 7 | 1 | Excellent |
12 | 4 | 4 | 3 | 4 | 4 | 4 | 4 | 7 | 1 | Excellent |
Item | Factor loading | Squared correlations | Standard Error of variance |
---|---|---|---|
Personal Continuity: general practitioner knows me | |||
1 I know this care provider very well. | 0.962 | 0.925 | 0.075 |
2 This care provider knows my medical history very well. | 0.976 | 0.953 | 0.047 |
3 This care provider always remembers what he/she did during my last visit(s). | 0.968 | 0.937 | 0.063 |
4 This care provider knows my family circumstances very well. | 0.957 | 0.916 | 0.084 |
5 This care provider knows what I do in my day-to-day life very well. | 0.941 | 0.885 | 0.115 |
Personal Continuity: general practitioner shows commitment | |||
1 This care provider contacts me when necessary without me having to ask him/her to do so. | 0.996 | 0.992 | 0.008 |
2 This care provider knows very well what I think is important when it comes to my care. | 0.984 | 0.968 | 0.032 |
3 This care provider maintains enough contact with me when I am seen by other care providers. | 0.976 | 0.953 | 0.047 |
Team/Cross-boundary Continuity related to Primary Care Providers | |||
1 These primary care providers pass on information to each other very well. | 0.996 | 0.992 | 0.008 |
2 These primary care providers work together very well. | 0.985 | 0.970 | 0.030 |
3 The primary care given by these care providers is well-connected. | 0.978 | 0.956 | 0.044 |
4 These primary care providers always know very well what the other care providers have done. | 0.990 | 0.980 | 0.020 |
Personal Continuity: Specialist knows me | |||
1 I know this care provider very well. | 0.911 | 0.830 | 0.170 |
2 This care provider knows my medical history very well. | 0.896 | 0.803 | 0.197 |
3 This care provider always remembers what he/she did during my last visit(s). | 0.925 | 0.856 | 0.144 |
4 This care provider knows my family circumstances very well. | 0.779 | 0.607 | 0.393 |
5 This care provider knows what I do in my day-to-day life very well. | 0.793 | 0.629 | 0.371 |
Personal Continuity: Specialist shows commitment | |||
1 This care providers contacts me when necessary without me having to ask him/her to do so. | 0.998 | 0.996 | 0.004 |
2 This care providers knows very well what I think is important when it comes to my care. | 0.991 | 0.982 | 0.018 |
3 This care providers maintains enough contact with me when I am seen by other care providers. | 0.967 | 0.935 | 0.065 |
Team/Cross-boundary Continuity related to Hospital care providers | |||
1 These hospital care providers pass on information to each other very well. | 0.969 | 0.939 | 0.061 |
2 These hospital care providers work together very well. | 0.925 | 0.856 | 0.144 |
3 The hospital care given by these care providers is well-connected. | 0.935 | 0.874 | 0.126 |
4 These care providers always know very well what the other care providers have done. | 0.960 | 0.922 | 0.078 |
Team/Cross-boundary Continuity between primary and hospital care providers | |||
1 These care providers pass on information to each other very well. | 0.967 | 0.935 | 0.065 |
2 These care providers work together very well. | 0.951 | 0.904 | 0.096 |
3 The care given by these care providers is well-connected. | 0.934 | 0.872 | 0.128 |
4 These care providers always know very well what the other care providers have done. | 0.940 | 0.884 | 0.116 |
Model fit | |||
Chi-square / DF | 2.656 | ||
GFI | 0.900 | ||
CFI | 0.982 | ||
TLI | 0.977 | ||
RMSEA | 0.061 | ||
SRMR | 0.005 |
Influencing factors of COC
Part | Maximum Score | Actual Score | The Standard Score |
---|---|---|---|
Personal Continuity: general practitioner knows me | 25 | 18.34 ± 4.49 | 73.37 ± 17.97 |
Personal Continuity: general practitioner shows commitment | 15 | 8.33 ± 3.56 | 55.54 ± 23.74 |
Team/Cross-boundary Continuity related to Primary Care Providers | 20 | 14.09 ± 3.73 | 70.45 ± 18.65 |
Personal Continuity: Specialist knows me | 25 | 15.51 ± 3.30 | 62.05 ± 13.18 |
Personal Continuity: Specialist shows commitment | 15 | 5.82 ± 1.94 | 38.84 ± 12.95 |
Team/Cross-boundary Continuity related to Hospital care providers | 20 | 14.10 ± 3.26 | 70.49 ± 16.29 |
Team/Cross-boundary Continuity between primary and hospital care providers | 20 | 13.37 ± 3.45 | 66.86 ± 17.26 |
Variable (Reference) | B | Standard error | P value | OR (95% CI) |
---|---|---|---|---|
Gender (Female) | 1.513 | 0.459 | 0.001 | 4.54 (2.87–7.19) |
Education level (College or higher) | 2.282 | 1.047 | 0.029 | 9.78 (3.44–27.91) |
Medical insurance (Yes) | 2.811 | 0.978 | < 0.001 | 16.63 (6.25–44.21) |
Family visit frequency (More) | 2.646 | 0.544 | < 0.001 | 14.09 (8.18–24.29) |
Blood Pressure Level (Normal) | 1.191 | 0.397 | 0.003 | 3.29 (2.21–4.89) |
Depression Status | 0.043 | 0.015 | 0.005 | 1.15 (1.03–1.06) |
General Health Perception | −0.096 | 0.036 | 0.007 | 0.908 (0.36–0.94) |