VOLUME 47 | NUMBER 5 | OCTOBER 2012
Care Coordination for the Chronically Ill: Understanding the Patient's Perspective
Keywords: Chronic disease; quality of care/patient safety (measurement); patient assessment/satisfaction.
Objective: To identify factors associated with perception of care coordination problems among chronically ill patients.
Methods: Patient-level data were obtained from a random-digit dial telephone survey of adults with chronic conditions. The survey measured respondents' self-report of care coordination problems and level of patient activation, using the Patient Activation Measure (PAM-13). Logistic regression was used to assess association between respondents' self-report of care coordination problems and a set of patient characteristics.
Results: Respondents in the highest activation stage had roughly 30–40 percent lower odds of reporting care coordination problems compared to those in the lowest stage (p <.01). Respondents with multiple chronic conditions were significantly more likely to report coordination problems than those with hypertension only. Respondents' race/ethnicity, employment, insurance status, income, and length of illness were not significantly associated with self-reported care coordination problems.
Conclusion: We conclude that patient activation and complexity of chronic illness are strongly associated with patients' self-report of care coordination problems. Developing targeted strategies to improve care coordination around these patient characteristics may be an effective way to address the issue.
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