Care coordination: what is it, what are its effects and can it be sustained?

Solberg, Leif I.

doi:10.1093/fampra/cmr071

Cited by 13 publications

(12 citation statements)

References 6 publications

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“… 18 This suggests that although the predicted increase in use of hospital services for children with CA may be primarily due to their complex needs and ill health, there may be scope for this to be reduced through increasing the efficiency of care coordination. 44 In terms of clinical implications, our findings provide the quantified, longitudinal evidence requested by the Chief Medical Officer, supporting the suggestion of key workers as a catalyst for efficient patient navigation through services. 3 Also, when adjusting for ill health, the predicted increase in use of hospital services and multidisciplinary referrals for children with CA reduces ( figure 1 ), suggesting higher usage may not be completely attributable to ill health, but affected by other factors such as deprivation and ethnicity.…”

Section: Discussionsupporting

confidence: 72%

Healthcare use for children with complex needs: using routine health data linked to a multiethnic, ongoing birth cohort

et al. 2018

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ObjectivesCongenital anomaly (CA) are a leading cause of disease, death and disability for children throughout the world. Many have complex and varying healthcare needs which are not well understood. Our aim was to analyse the healthcare needs of children with CA and examine how that healthcare is delivered.DesignSecondary analysis of observational data from the Born in Bradford study, a large prospective birth cohort, linked to primary care data and hospital episode statistics. Negative binomial regression with 95% CIs was performed to predict healthcare use. The authors conducted a subanalysis on referrals to specialists using paper medical records for a sample of 400 children.SettingPrimary, secondary and tertiary healthcare services in a large city in the north of England.ParticipantsAll children recruited to the birth cohort between March 2007 and December 2011. A total of 706 children with CA and 10 768 without CA were included in the analyses.Primary and secondary outcome measuresHealthcare use for children with and without CA aged 0 to <5 years was the primary outcome measure after adjustment for confounders.ResultsPrimary care consultations, use of hospital services and referrals to specialists were higher for children with CA than those without. Children in economically deprived neighbourhoods were more likely to be admitted to hospital than consult primary care. Children with CA had a higher use of hospital services (β 1.48, 95% CI 1.36 to 1.59) than primary care consultations (β 0.24, 95% CI 1.18 to 0.30). Children with higher educated mothers were less likely to consult primary care and hospital services.ConclusionsHospital services are most in demand for children with CA, but also for children who were economically deprived whether they had a CA or not. The complex nature of CA in children requires multidisciplinary management and strengthened coordination between primary and secondary care.

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Section: Discussionsupporting

confidence: 72%

Healthcare use for children with complex needs: using routine health data linked to a multiethnic, ongoing birth cohort

et al. 2018

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“…When considering affordability, the model seems costly when reduced to the number of beneficiaries, but data are not available to describe the potential cost of non-intervention. It would seem that evaluating the cost-benefit ratio of care coordination interventions is often very difficult, but costs are generally high [25,26].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a Care Coordination Initiative in Improving Access to Dental Care for Persons with Disability

Gondlach

Catteau

Hennequin

et al. 2019

IJERPH

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In French law, the state is responsible for ensuring equal access to health care for people with disabilities. No system exists within dentistry to guarantee this—there are no salaried public service workers, over 85% of dentists work in general practice, and hospital dentistry is poorly developed. Public funding is available for care coordination initiatives termed “Health Networks”. The objective of this study is to report on an internal evaluation of the Réseau Santé Bucco-Dentaire et Handicap de la région Rhône-Alpes (RSBDH), a Health Network coordinating dentistry for persons with disability in the Rhône-Alpes region, and to discuss the French model of Health Networks as a response to improve access to care. Existing governmental guidelines for the evaluation of Networks were adapted for the RSBDH. The RSBDH coordinated dentists to ensure screening, prevention, and treatment for 3219 persons with disability in 2015. Identified strengths included the identification of vulnerable persons, improved access to treatment and collaboration with primary care services. Weaknesses included training of professionals, continuity of care, information sharing, and stakeholder participation. In 2015, the cost was €501 per patient. This model raises major issues of cost, training, equity, and quality of care within special care dentistry. This discussion is relevant to many countries where models of service provision are currently being developed.

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“…CC depends upon the way the service providers function. Teamwork among service providers enables an effective information transfer and enhances delivery of quality care to the patients (Gittell, 2009; Kibbe, 2002; Solberg, 2011). Thus, there is a linkage between inter-professional teamwork and quality of CC.…”

Section: Data Analysis and Resultsmentioning

confidence: 99%

“…It aims to be patient-centric, where the services are expected to be flexible so as to meet patients’ varying needs and are delivered through a minimum number of professionals following the norms of the therapeutic relationship (Rosenbach & Young, 2000). The focus of coordinated care is on orchestrating the efforts of doctors, nurses and administrative resources for enhancement in patient experience (Segal, Dunt, & Day, 2004; Solberg, 2011).…”

Section: Introductionmentioning

confidence: 99%

Developing a Care Coordination Model Using a Hybrid DEMATEL and PLS-SEM Approach

Prakash

Srivastava

2019

IIM Kozhikode Society & Management Review

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With the evolving living conditions of people, expectations with regard to health care systems are also changing across the world. International bodies and national governments have started giving due consideration to the development of effective health care systems through policy reforms and effective regulation (Prakash, 2015). Governments need to realize that health is a social phenomenon and a hospital is a social institution which is affected by the socioeconomic and political conditions of its environment (Wang, Wan, Clement, & Begun, 2001). Inadequate infrastructure, ineffective manpower and high load of patients are some of the major challenges of the Indian health care system (Bajpai, 2014). Achieving a high level of coordination becomes difficult, because hospitals are organized into

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Care coordination: what is it, what are its effects and can it be sustained?

Cited by 13 publications

References 6 publications

Healthcare use for children with complex needs: using routine health data linked to a multiethnic, ongoing birth cohort

Healthcare use for children with complex needs: using routine health data linked to a multiethnic, ongoing birth cohort

Evaluation of a Care Coordination Initiative in Improving Access to Dental Care for Persons with Disability

Developing a Care Coordination Model Using a Hybrid DEMATEL and PLS-SEM Approach

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