Change in health care use after coordinated care planning: a quasi-experimental study

Bielska, Iwona A.; Cimek, Kelly; Guenter, Dale; O’Halloran, Kelly; Nyitray, Chloe; Hunter, Linda; Wodchis, Walter P.

doi:10.9778/cmajo.20170053

Cited by 3 publications

(1 citation statement)

References 19 publications

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“…Based on available case report data, it is anticipated that this intervention is a cost-effective initiative that will reduce ED visits and hospital admissions through enhanced care coordination. 28,29 Long-term follow-up of patients post-TIP to evaluate health system use is in progress. The TIP model achieves synchronous connection of patients with multimorbidity and their PCPs in an interprofessional case consultation focused on what is most important to the patient.…”

Section: S61mentioning

confidence: 99%

Connecting People With Multimorbidity to Interprofessional Teams Using Telemedicine

et al. 2019

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PURPOSE Most models for managing chronic disease focus on single diseases. Managing patients with multimorbidity is an increasing challenge in family medicine. We evaluated the feasibility of a novel approach to caring for patients with multimorbidity, performing a case study of TIP-Telemedicine IMPACT (Interprofessional Model of Practice for Aging and Complex Treatments) Plus-a 1-time interprofessional consultation with primary care physicians (PCPs) and their patients in Toronto, Canada. METHODSWe assessed feasibility of the TIP model from the number of referrals from PCPs and emergency departments in Toronto, Canada; the intervention cost; and the satisfaction of patients, PCPs, and team members with the new model. One patient and PCP story highlights the model's impact. We also performed thematic analysis of written feedback. RESULTSA total of 76 patients were referred from 53 PCPs and 4 emergency departments, and 65 PCPs participated in TIP. All 74 patient survey respondents indicated TIP improved their access to interdisciplinary resources, and 97% reported feeling hopeful their conditions would improve as a result. Of 21 PCP survey respondents, 100% reported they would use TIP again, and 90% reported improved confidence in managing their patient's care. Of 87 team member survey respondents, 97% rated TIP as effective. Qualitative findings indicated benefits to both patients and health professionals. The cost was about 22% less than that of a 1-day hospital admission through the emergency department (C$854 vs C$1,088).CONCLUSIONS TIP is a feasible intervention in multiple primary care settings that gives patients an active role in their health management, supported by their team. The model effectively addresses the needs of the most complex patients and their PCPs.To read or post commentaries in response to this article, see it online at http://www.AnnFamMed.org/content/17/Suppl_1/S57.

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Section: S61mentioning

confidence: 99%

Connecting People With Multimorbidity to Interprofessional Teams Using Telemedicine

et al. 2019

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Patients report high information coordination between rostered primary care physicians and specialists: A cross-sectional study

Rahman,

Babe,

Griffith

et al. 2024

PLoS ONE

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Our study aimed to describe patient experience of information coordination between their primary care physician and specialists and to examine the associations between their experience and their personal and primary care characteristics. We conducted a cross-sectional study of Ontario residents rostered to a primary care physician and visited a specialist physician in the previous 12 months by linking population-based health administrative data to the Health Care Experience Survey collected between 2013 and 2020. We described respondents’ sociodemographic and health care utilization characteristics and their experience of information coordination between their primary care physician and specialists. We measured the adjusted association between patient-reported measures of information coordination before and after respondents received care from a specialist physician and their type of primary care model. 1,460 out 20,422 (weighted 7.5%) of the respondents reported that their specialist physician did not have basic medical information about their visit from their primary care physician in the previous 12 months. 2,298 out of 16,442 (weighted 14.9%) of the respondents reported that their primary care physician seemed uninformed about the care they received from the specialist. Females, younger individuals, those with a college or undergraduate level of education, and users of walk-in clinics had a higher likelihood of reporting a lack of information coordination between the primary care and specialist physicians. Only respondents rostered to an enhanced fee-for-service model had a higher odds of reporting that the specialist physician did not have basic medical information about their visit compared to those rostered to a Family Health Team (OR 1.22, 95% Cl 1.12–1.40). We found no significant association between respondent’s type of primary care model and that their primary care physician was uninformed about the care received from the specialist physician. In this population-based health study, respondents reported high information coordination between their primary care physician and specialists. Except for respondents rostered to an enhanced fee-for-service model of care, we did not find any difference in information coordination across other primary care models.

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Assessing the Removal of Regional Health Authorities in Ontario

Barker

2021

Canadian Public Policy

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A little more than a decade ago, a series of regional bodies were introduced throughout Ontario to help resolve difficulties with the province’s health care system. The Local Health Integration Networks, the name given to the new health entities, sought to create a connected set of health services and to achieve more effective control and distribution of health care finances. A third intent was to engage the community when setting priorities for health care. Recently, the new government of Ontario replaced the LHINs with a single health authority. It asserted that the single authority was better equipped to handle the many problems that still prevailed. An assessment of this decision offers some grounds for disbanding the LHINs. However, the findings offer stronger support for the alternative of keeping the regional authorities and providing them with greater autonomy.

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Change in health care use after coordinated care planning: a quasi-experimental study

Abstract: Care plan enrollees show a decrease in the number of times they visit emergency departments, which may be attributed to integrated and coordinated care planning. This association should be examined to see whether these reductions persist for more than 1 year.

Cited by 3 publications

References 19 publications

Connecting People With Multimorbidity to Interprofessional Teams Using Telemedicine

Connecting People With Multimorbidity to Interprofessional Teams Using Telemedicine

Patients report high information coordination between rostered primary care physicians and specialists: A cross-sectional study

Assessing the Removal of Regional Health Authorities in Ontario

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