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This analysis explores the intricate relationship between continuity of care and treatment outcomes in advanced prostate cancer patients within the Medicare system. Specifically, it sheds light on the impact of racial disparities on these healthcare dynamics, offering fresh insights for improved patient care strategies.

  • Higher continuity of care is linked to reduced emergency room visits, hospitalizations, and costs.
  • Continuity of care also reduces long-term mortality rates.
  • The benefits of higher continuity of care are more pronounced for African American patients compared to White patients.
  • Continuity of care is particularly significant given the range of treatment options available and the prolonged nature of the disease.

According to a retrospective cohort study published in the journal Cancer Medicine, continuity of care plays an integral role in the effective management of advanced prostate cancer. The researchers established that a unit increase in continuity of care (measured using the Continuity of Care Index (COCI) and Usual Provider Care Index (UPCI) correlates with reductions in emergency room visits, hospitalizations, and associated costs. In addition, this continuity significantly lessens the hazard of long-term mortality, highlighting the impact of maintaining consistent patient-provider relationships.

Racial Variation: Greater Benefits for African American Patients

Interestingly, the benefits of higher continuity of care were found to be more substantial for African American patients than for White patients. For African American patients, a unit increase in continuity of care was associated with a 38% lower incident rate of emergency room visits and a 42% lower incident rate of hospitalizations. These figures indicate the crucial role of maintaining consistent healthcare relationships in addressing racial disparities in prostate cancer care.

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Implications for Clinical Care, Research, and Policy Practices

These findings have substantial implications for clinical practices, research pursuits, and health policy practices (such as capitation vs. incentive payment). Continuity of care is integral not just in advanced prostate cancer management but also in managing various other conditions, including dementia, diabetes, and lung cancer. Clinicians are advised to emphasize continuity in their interactions with patients, as these relationships can significantly improve patients’ outcomes.

Furthermore, the researchers recommended that efforts be made to integrate appropriate strategies to promote continuity of care in survivorship care plans, especially for African American patients. Such strategies may include implementing patient-centered coordinated care models and encouraging effective collaboration among primary care physicians and specialists.

The Role of Continuity of Care in Survivorship

As the number of prostate cancer survivors continues to grow, effective survivorship care becomes an increasingly critical element of the prostate cancer care continuum. This study’s findings underscore the importance of continuity of care in ensuring improved short- and long-term outcomes for survivors. The greater magnitude of benefits observed for African American patients, coupled with a growing shortage of oncologists, calls for a strategic focus on promoting better transitions for these patients to primary care providers who can provide skilled support and care.


Jayadevappa, R., Guzzo, T., Vapiwala, N., Malkowicz, S. B., Gallo, J. J., & Chhatre, S. (2023). Continuity of care and advanced prostate cancer. Cancer Medicine. https://doi.org/10.1002/cam4.5845