PATIENTS with chronic lymphocytic leukemia (CLL) who consistently saw the same oncologist or hematologist experienced significantly fewer emergency room visits and hospitalizations, according to a large real-world study of nearly 6,000 individuals treated with covalent Bruton tyrosine kinase inhibitor (cBTKi) therapy.
The analysis, based on Optum’s de-identified Clinformatics Data Mart Database, measured continuity of care (CoC) using the Herfindahl-Hirschman Index, where scores closer to 1.0 represent stronger provider continuity. The median CoC score among the cohort was 0.72, with a follow-up period of nearly 32 months.
Higher levels of continuity were strongly associated with better health outcomes. Patients with greater CoC had lower odds of emergency room use (odds ratio [OR]: 0.89, 95% CI: 0.87–0.91, p<0.0001) and lower frequency of emergency visits (rate ratio [RR]: 0.93, 95% CI: 0.92–0.94, p<0.0001). Hospitalization risk was also reduced, with significantly fewer inpatient admissions (OR: 0.85, 95% CI: 0.84–0.87, p<0.0001) and hospital stays (RR 0.89, 95% CI: 0.88–0.90, p < 0.0001). Despite these benefits, continuity of care was not linked to improved overall survival, with hazard ratios showing no significant differences in mortality risk between higher and lower continuity groups. Researchers note that the retrospective design limits causal inference, though sensitivity and post-hoc analyses supported the observed associations. The findings underscore the potential importance of maintaining consistent specialist care for patients with CLL receiving cBTKi therapy. While survival outcomes did not improve, reductions in acute care utilization highlight a clear advantage to continuity, which may ease the burden on both patients and healthcare systems. Reference: Gabella S et al. Continuity of care for patients with chronic lymphocytic leukemia: an analysis of real-world data. J Med Econ. 2025;1-13.
