Effect of Patient-Centred Communication and Usual Source of Care on Potentially Preventable Hospitalization among Patients with Chronic Diseases and Disabilities

Abstract

Abstract Background: This study examined the effect of the degree of patient-centred communication (PCC) and having a usual source of care (USC) on potentially preventable hospitalization (PPH) among chronic disease patients with disability. In particular, we empirically analysed whether PCC and USC could reduce the possibility of PPH among patients with disabilities compared to that among those without disabilities. Methods: This study used data from the Korean Health Panel Survey 2017-2018 (7,271 patients without disabilities and 774 patients with disabilities). The dependent variable was extracted from the 2018 KHPS data, while all other variables included in the analysis were extracted from the 2017 KHPS data and subjected to multivariate logistic regression analysis; subgroup analysis was performed according to the severity of disability. Results: The incidence of PPH was higher in the group with disabilities (4.5%) than in the group without disabilities (2.2%). Significantly more patients with disabilities than those without disabilities had a USC (67.7% vs. 56.9%), and more patients with severe disabilities than those with mild disabilities had a USC (75.9% vs. 63.5%). Multivariate logistic regression analysis showed that the risk of PPH increased when PCC was insufficient in patients with disabilities (OR = 2.92, 95%CI [1.41–6.04]), those with mild disabilities (OR = 2.51, 95%CI [1.02–6.20]), and those in the severe disability group who did not have a USC (OR = 5.06, 95%CI [1.03–24.80]). The effects of USCs and PCC on PPH were not observed in patients without disabilities. Conclusion: Sufficient PCC and having a USC helped reduce the incidence of PPH among patients with disabilities and chronic conditions. It is necessary to find practical ways to enhance PCC and expand the use of USCs among patients with disabilities so that they can receive appropriate primary healthcare services in a timely manner.