scholarly journals Patient-Reported Care Coordination: Associations With Primary Care Continuity and Specialty Care Use

2011 ◽  
Vol 9 (4) ◽  
pp. 323-329 ◽  
Author(s):  
D. T. Liss ◽  
J. Chubak ◽  
M. L. Anderson ◽  
K. W. Saunders ◽  
L. Tuzzio ◽  
...  
2017 ◽  
Vol 57 (1) ◽  
pp. 5-10 ◽  
Author(s):  
Katherine Hobbs Knutson ◽  
Mark J. Meyer ◽  
Nisha Thakrar ◽  
Bradley D. Stein

Many children are treated for mental health disorders in primary care settings. The system of care (SOC) provides a framework for collaboration among pediatric mental health providers, but it is unclear if youth treated for mental health disorders in primary care receive such coordination. At the South Boston Community Health Center from September /2012 to August 2013 for 74 individuals ≤18 years, the odds of contact with SOC agencies (mental health, education, child protective services, juvenile justice and developmental disabilities) were compared for mental health treatment in primary versus specialty care. The odds of SOC contact within primary care were lower compared to specialty care (OR = 0.43, 95% CI = 0.29-0.66), specifically for mental health (OR = 0.54, 95% CI = 0.25-1.2), education (OR = 0.12, 95% CI = 0.050-0.28), and child protective services (OR = 0.64, 95% CI = 0.22-1.9). As care coordination may improve health outcomes, increased support and education for care coordination specific to youth treated for mental health disorders in primary care settings may be warranted.


2015 ◽  
Vol 60 (9) ◽  
pp. 2628-2635 ◽  
Author(s):  
Lauren A. Beste ◽  
Bonnie K. Harp ◽  
Rebecca K. Blais ◽  
Ginger A. Evans ◽  
Susan L. Zickmund

2018 ◽  
Vol 18 (7) ◽  
pp. 797-804 ◽  
Author(s):  
Corinna J. Rea ◽  
Larissa M. Wenren ◽  
Katherine D. Tran ◽  
Eric Zwemer ◽  
Daniel Mallon ◽  
...  

2020 ◽  
Vol 55 (5) ◽  
pp. 660-670
Author(s):  
Varsha G. Vimalananda ◽  
Mark Meterko ◽  
Shirley Qian ◽  
Jolie B. Wormwood ◽  
Amanda Solch MSW ◽  
...  

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Janet Prvu Bettger ◽  
Stacy Lender ◽  
Diane Nutter ◽  

Background: Facilitating care continuity from hospital to home has been shown for other disease states to reduce adverse health events. In this study we examined whether weekend discharges were less likely to have a follow-up appointment scheduled with either primary or specialty care for acute stroke patients discharged home. Methods: We examined data from 44 hospitals participating in the Ohio Coverdell Stroke program to determine the proportion of adult stroke patients discharged home who had a follow-up appointment scheduled with primary care or with specialty care (neurology, neurosurgery, or neurology provider) and whether this varied by patients’ hospital discharge day of the week (weekday vs. weekend). Facilitators and barriers to scheduling appointments prior to discharge were reported by stroke team members at a meeting of participating hospitals. Results: Among 44 hospitals, there were 4,635 patients discharged home from April-December 2013. Prior to discharge, hospital staff scheduled follow-up appointments for post-discharge care with a primary care provider for 15.2% of patients and with a specialty care provider for 27.2% of patients. A higher proportion of patients with a weekday discharge compared with weekend discharge had a follow-up appointment with primary care (16.4% vs. 8.5%, p<0.001) and specialty care (29.6% vs. 17.5%, p<0.001). Reported barriers to facilitating care continuity for weekend patient discharges included lack of availability of dedicated weekend hospital personnel to plan appointments with the patient and family, and limited or no access to online or electronic appointment scheduling or primary or specialty care office staff to schedule appointments. Conclusions: Although a significant number of patients were discharged home without a primary or specialty care appointment, patients discharged on the weekend were at a disadvantage for having a follow-up appointment scheduled prior to hospital discharge. Discharge planning earlier in the hospital stay and creative approaches to improving appointment scheduling with community-based providers could be explored as options for promoting improved care continuity for weekend discharges.


BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e042551
Author(s):  
Andrea L Hernan ◽  
Sally J Giles ◽  
Andrew Carson-Stevens ◽  
Mark Morgan ◽  
Penny Lewis ◽  
...  

BackgroundPatient engagement in safety has shown positive effects in preventing or reducing adverse events and potential safety risks. Capturing and utilising patient-reported safety incident data can be used for service learning and improvement.ObjectiveThe aim of this study was to characterise the nature of patient-reported safety incidents in primary care.DesignSecondary analysis of two cross sectional studies.ParticipantsAdult patients from Australian and English primary care settings.MeasuresPatients’ self-reported experiences of safety incidents were captured using the validated Primary Care Patient Measure of Safety questionnaire. Qualitative responses to survey items were analysed and categorised using the Primary Care Patient Safety Classification System. The frequency and type of safety incidents, contributory factors, and patient and system level outcomes are presented.ResultsA total of 1329 patients (n=490, England; n=839, Australia) completed the questionnaire. Overall, 5.3% (n=69) of patients reported a safety incident over the preceding 12 months. The most common incident types were administration incidents (n=27, 31%) (mainly delays in accessing a physician) and incidents involving diagnosis and assessment (n=16, 18.4%). Organisation of care accounted for 27.6% (n=29) of the contributory factors identified in the safety incidents. Staff factors (n=13, 12.4%) was the second most commonly reported contributory factor. Where an outcome could be determined, patient inconvenience (n=24, 28.6%) and clinical harm (n=21, 25%) (psychological distress and unpleasant experience) were the most frequent.ConclusionsThe nature and outcomes of patient-reported incidents differ markedly from those identified in studies of staff-reported incidents. The findings from this study emphasise the importance of capturing patient-reported safety incidents in the primary care setting. The patient perspective can complement existing sources of safety intelligence with the potential for service improvement.


2021 ◽  
Vol 10 (8) ◽  
pp. 1782
Author(s):  
Ignacio Ricci-Cabello ◽  
Aina María Yañez-Juan ◽  
Maria A. Fiol-deRoque ◽  
Alfonso Leiva ◽  
Joan Llobera Canaves ◽  
...  

We aimed to examine the complex relationships between patient safety processes and outcomes and multimorbidity using a comprehensive set of constructs: multimorbidity, polypharmacy, discordant comorbidity (diseases not sharing either pathogenesis nor management), morbidity burden and patient complexity. We used cross-sectional data from 4782 patients in 69 primary care centres in Spain. We constructed generalized structural equation models to examine the associations between multimorbidity constructs and patient-reported patient safety (PREOS-PC questionnaire). These associations were modelled through direct and indirect (mediated by increased interactions with healthcare) pathways. For women, a consistent association between higher levels of the multimorbidity constructs and lower levels of patient safety was observed via either pathway. The findings for men replicated these observations for polypharmacy, morbidity burden and patient complexity via indirect pathways. However, direct pathways showed unexpected associations between higher levels of multimorbidity and better safety. The consistent association between multimorbidity constructs and worse patient safety among women makes it advisable to target this group for the development of interventions, with particular attention to the role of comorbidity discordance. Further research, particularly qualitative research, is needed for clarifying the complex associations among men.


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