March 20, 2012
Michelle M. Doty, Anne-Marie J. Audet, M.D., Ashley-Kay Fryer
M. M. Doty, A.-K. Fryer, and A.-M. J. Audet, "The Role of Care Coordinators in Improving Care Coordination: The Patient's Perspective," Archives of Internal Medicine, published online March 12, 2012.
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Nearly half of all Americans live with at least one chronic condition. Of these adults, one of four sees at least three physicians, and the typical primary care physician coordinates care with 229 other physicians in 117 different practices. It is perhaps not surprising then that people with chronic conditions are at high risk of having poorly coordinated care that results in duplication of lab tests, medical errors, and adverse health outcomes.
Using data from the 2010 Commonwealth Fund International Health Policy Survey, encompassing more than 11,000 adults in 11 countries, the authors reported the effects that having a care coordinator, better access to primary care, and strong health care provider–patient communication have on care coordination.
What the Study Found
The Commonwealth Fund researchers found that patients who have a care coordinator were less likely than patients without one to report that:
- their care was poorly organized and coordinated
- their test results or medical records were not available at their scheduled appointments
- they received conflicting information from different physicians
- they did not receive follow-up
- their regular physicians and specialists were not sharing information about their care.
The researchers also found positive associations between having accessible care and experiencing fewer coordination gaps, as well as between having a strong provider–patient relationship and experiencing fewer coordination gaps.
The Affordable Care Act includes provisions to support physician practices in becoming patient-centered medical homes, where patients would be able to receive accessible, coordinated care. Provisions in the law to support medical homes include state grants to establish community health teams that will help primary care practices provide 24-hour care management and hospital discharge transition.