Impact of different models of improvement of continuity of care on lipid control and the delay of visits to cardiology

Future Cardiol. 2020 Jan;16(1):33-41. doi: 10.2217/fca-2018-0083. Epub 2019 Dec 10.

Abstract

Aims: To analyze the impact of implementing three different models of continuity of care on the delay of first visits to the cardiologist (management end point) and on LDL-cholesterol control rates among patients with atherosclerotic vascular disease (clinical end point). Methods: Observational, longitudinal and retrospective study of patients with cardiovascular disease and LDL-cholesterol ≥70 mg/dl attended in three hospitals (H1/H2/H3). In H1 and H2, a virtual system (telecardiology) was developed (in H1, internal audits and specific medical education were also performed). In H3 a cardiologist was integrated into the primary care center. Results: The delay of visits to cardiologist significantly improved from 66.5 ± 29.1 days to 34.1 ± 14.1 days (p < 0.001), as well as the intensification of lipid-lowering treatment and the achievement of lipid goals. LDL-cholesterol control rates were higher in H1 and the reduction of the delay of visits in H3. Conclusion: Continuity of care is associated with improvements in management and clinical end points.

Keywords: LDL cholesterol; cardiology; continuity of care; integration; primary care; telecardiology.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Biomarkers / blood
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / therapy*
  • Continuity of Patient Care / standards*
  • Female
  • Follow-Up Studies
  • Hospitalization / trends*
  • Humans
  • Lipids / blood*
  • Male
  • Primary Health Care / methods*
  • Quality Improvement*
  • Retrospective Studies

Substances

  • Biomarkers
  • Lipids