{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T11:57:56Z","timestamp":1785326276048,"version":"3.55.0"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2023,4,8]],"date-time":"2023-04-08T00:00:00Z","timestamp":1680912000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100013362","name":"Swiss Cancer Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100013362","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Swiss Cancer League","award":["HSR-4944-11-2019"],"award-info":[{"award-number":["HSR-4944-11-2019"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Continuity of care (COC) was shown to be associated with fewer hospitalizations. We aimed to evaluate whether COC was associated with intensive intervention(s) at the end of life (IEOL), a preference-sensitive outcome, in cancer patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The study is based on claims data of patients with incident use of anti-neoplastics in Switzerland. COC Index, Usual Provider Continuity score, Sequential Continuity index and Modified Modified Continuity Index were calculated based on consultations with the usual ambulatory care physician. Treatment intensity was evaluated in the last 6 months of life, and COC was evaluated in months 18\u20136 before death in those who died between 24 and 54\u2009months after incident cancer. IEOL comprised life-sustaining interventions (cardiac catheterization, cardiac assistance device implantation, pulmonary artery wedge monitoring, cardiopulmonary resuscitation\/cardiac conversion, gastrostomy, blood transfusion, dialysis, mechanical ventilator utilization and intravenous antibiotics) and measures specifically used in cancer patients (last dose of chemotherapy \u226414\u2009days of death, a new chemotherapy regimen starting &amp;lt;30\u2009days before death, \u22651 emergency visit in the last month of life, \u22651 hospital admission or spending &amp;gt;14\u2009days in hospital in the last month of life and death in an acute-care hospital).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>All COC scores were inversely associated with the occurrence of an IEOL, as were older age, homecare nursing utilization and density of ambulatory care physicians. For COC Index, odds ratio was 0.55 (95% confidence interval 0.37\u20130.83).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>COC scores were consistently and inversely related to IEOL. The study supports efforts to improve COC for cancer patients at their end of life.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/eurpub\/ckad047","type":"journal-article","created":{"date-parts":[[2023,4,8]],"date-time":"2023-04-08T15:57:11Z","timestamp":1680969431000},"page":"396-402","source":"Crossref","is-referenced-by-count":7,"title":["Continuity of care and treatment intensity at the end of life in Swiss cancer patients"],"prefix":"10.1093","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4650-1463","authenticated-orcid":false,"given":"Caroline","family":"B\u00e4hler","sequence":"first","affiliation":[{"name":"Department of Health Sciences, Helsana Group , Z\u00fcrich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"N\u00e4pflin","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Helsana Group , Z\u00fcrich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Scherer","sequence":"additional","affiliation":[{"name":"Department of General Practice, Primary Care, University Medical Center Hamburg-Eppendorf , Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Blozik","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Helsana Group , Z\u00fcrich, Switzerland"},{"name":"Institute of Primary Care, University of Z\u00fcrich , Z\u00fcrich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,4,8]]},"reference":[{"key":"2023060120112471000_ckad047-B1","doi-asserted-by":"crossref","first-page":"2571","DOI":"10.1002\/cncr.26536","article-title":"Ensuring quality cancer care: a follow-up review of the Institute of Medicine's 10 recommendations for improving the quality of cancer care in America","volume":"118","author":"Spinks","year":"2012","journal-title":"Cancer"},{"key":"2023060120112471000_ckad047-B2","doi-asserted-by":"crossref","first-page":"481","DOI":"10.2147\/CMAR.S156566","article-title":"Intensity of treatment in Swiss cancer patients at the end-of-life","volume":"10","author":"B\u00e4hler","year":"2018","journal-title":"Cancer Manag Res"},{"key":"2023060120112471000_ckad047-B3","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1258\/135581906778476562","article-title":"Does continuity of care with a family physician reduce hospitalizations among older adults?","volume":"11","author":"Menec","year":"2006","journal-title":"J Health Serv Res Policy"},{"key":"2023060120112471000_ckad047-B4","doi-asserted-by":"crossref","first-page":"1671","DOI":"10.1001\/archinternmed.2010.340","article-title":"A longitudinal examination of continuity of care and avoidable hospitalization: evidence from a universal coverage health care system","volume":"170","author":"Cheng","year":"2010","journal-title":"Arch Intern Med"},{"key":"2023060120112471000_ckad047-B5","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1177\/0269216313493125","article-title":"Are family physician visits and continuity of care associated with acute care use at end-of-life? 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