Continuity of care across sectors in patients with type 2 diabetes: A nationwide register study in Denmark

Anne Sofie Baymler Lundberg; Annelli Sandbæk; Claus Høstrup Vestergaard; Anders Prior

doi:10.1016/j.pcd.2025.02.004

Continuity of care across sectors in patients with type 2 diabetes: A nationwide register study in Denmark

Anne Sofie Baymler Lundberg, Annelli Sandbæk, Claus Høstrup Vestergaard, Anders Prior

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

Abstract

Aims: Our aims were to describe health care utilisation patterns across sectors in patients with type 2 diabetes(T2D), and to identify patient characteristics associated with low continuity of care. Methods: A nationwide register-based cohort study including all Danish citizens recorded with a diagnosis of T2 diabetes in 2017. The outcome was continuity of care as measured by three different indices: the Continuity of Care Index (COCI), the Usual Provider of Care Index (UPC), and the Sequential Continuity Index (SECON). Results: The median of patients with T2D had 75 % of their contacts to their usual health care provider. The strongest association with low continuity of care was the number of comorbidities, showing a dose response trend. Other patient characteristics associated with low continuity of care were duration of T2 diabetes (>10.3 years), lower age group (40–49 years), having a high education level (>15 years) and having a cancer comorbidity. Conclusions: Our study was the first step to flag patients at potential risk of fragmented care due to many transitions between providers. This is of importance for the general practitioners, who are the coordinators of the patients with T2D and their various health conditions and contacts.

Original language	English
Journal	Primary Care Diabetes
ISSN	1751-9918
DOIs	https://doi.org/10.1016/j.pcd.2025.02.004
Publication status	Accepted/In press - 15 Feb 2025

Keywords

Cohort studies
Continuity of patient care
Diabetes Mellitus*/epidemiology
Diabetes mellitus
Health services
Registries

Access to Document

10.1016/j.pcd.2025.02.004Licence: CC BY

Cite this

@article{5a56b84726824bc8a1e7e22a584ae8c4,

title = "Continuity of care across sectors in patients with type 2 diabetes: A nationwide register study in Denmark",

abstract = "Aims: Our aims were to describe health care utilisation patterns across sectors in patients with type 2 diabetes(T2D), and to identify patient characteristics associated with low continuity of care. Methods: A nationwide register-based cohort study including all Danish citizens recorded with a diagnosis of T2 diabetes in 2017. The outcome was continuity of care as measured by three different indices: the Continuity of Care Index (COCI), the Usual Provider of Care Index (UPC), and the Sequential Continuity Index (SECON). Results: The median of patients with T2D had 75 % of their contacts to their usual health care provider. The strongest association with low continuity of care was the number of comorbidities, showing a dose response trend. Other patient characteristics associated with low continuity of care were duration of T2 diabetes (>10.3 years), lower age group (40–49 years), having a high education level (>15 years) and having a cancer comorbidity. Conclusions: Our study was the first step to flag patients at potential risk of fragmented care due to many transitions between providers. This is of importance for the general practitioners, who are the coordinators of the patients with T2D and their various health conditions and contacts.",

keywords = "Cohort studies, Continuity of patient care, Diabetes Mellitus*/epidemiology, Diabetes mellitus, Health services, Registries",

author = "Lundberg, {Anne Sofie Baymler} and Annelli Sandb{\ae}k and Vestergaard, {Claus H{\o}strup} and Anders Prior",

year = "2025",

month = feb,

day = "15",

doi = "10.1016/j.pcd.2025.02.004",

language = "English",

journal = "Primary Care Diabetes",

issn = "1751-9918",

publisher = "Elsevier Ltd",

}

Continuity of care across sectors in patients with type 2 diabetes: A nationwide register study in Denmark. / Lundberg, Anne Sofie Baymler ; Sandbæk, Annelli; Vestergaard, Claus Høstrup et al.
In: Primary Care Diabetes, 15.02.2025.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Continuity of care across sectors in patients with type 2 diabetes: A nationwide register study in Denmark

AU - Lundberg, Anne Sofie Baymler

AU - Sandbæk, Annelli

AU - Vestergaard, Claus Høstrup

AU - Prior, Anders

PY - 2025/2/15

Y1 - 2025/2/15

N2 - Aims: Our aims were to describe health care utilisation patterns across sectors in patients with type 2 diabetes(T2D), and to identify patient characteristics associated with low continuity of care. Methods: A nationwide register-based cohort study including all Danish citizens recorded with a diagnosis of T2 diabetes in 2017. The outcome was continuity of care as measured by three different indices: the Continuity of Care Index (COCI), the Usual Provider of Care Index (UPC), and the Sequential Continuity Index (SECON). Results: The median of patients with T2D had 75 % of their contacts to their usual health care provider. The strongest association with low continuity of care was the number of comorbidities, showing a dose response trend. Other patient characteristics associated with low continuity of care were duration of T2 diabetes (>10.3 years), lower age group (40–49 years), having a high education level (>15 years) and having a cancer comorbidity. Conclusions: Our study was the first step to flag patients at potential risk of fragmented care due to many transitions between providers. This is of importance for the general practitioners, who are the coordinators of the patients with T2D and their various health conditions and contacts.

AB - Aims: Our aims were to describe health care utilisation patterns across sectors in patients with type 2 diabetes(T2D), and to identify patient characteristics associated with low continuity of care. Methods: A nationwide register-based cohort study including all Danish citizens recorded with a diagnosis of T2 diabetes in 2017. The outcome was continuity of care as measured by three different indices: the Continuity of Care Index (COCI), the Usual Provider of Care Index (UPC), and the Sequential Continuity Index (SECON). Results: The median of patients with T2D had 75 % of their contacts to their usual health care provider. The strongest association with low continuity of care was the number of comorbidities, showing a dose response trend. Other patient characteristics associated with low continuity of care were duration of T2 diabetes (>10.3 years), lower age group (40–49 years), having a high education level (>15 years) and having a cancer comorbidity. Conclusions: Our study was the first step to flag patients at potential risk of fragmented care due to many transitions between providers. This is of importance for the general practitioners, who are the coordinators of the patients with T2D and their various health conditions and contacts.

KW - Cohort studies

KW - Continuity of patient care

KW - Diabetes Mellitus/epidemiology

KW - Diabetes mellitus

KW - Health services

KW - Registries

UR - http://www.scopus.com/inward/record.url?scp=85217939934&partnerID=8YFLogxK

U2 - 10.1016/j.pcd.2025.02.004

DO - 10.1016/j.pcd.2025.02.004

M3 - Journal article

SN - 1751-9918

JO - Primary Care Diabetes

JF - Primary Care Diabetes

ER -

Continuity of care across sectors in patients with type 2 diabetes: A nationwide register study in Denmark

Abstract

Keywords

Access to Document

Other files and links

Fingerprint

Cite this