Collaboration in Health Care and Social Service Networks for Older Adults: Association With Health Care Utilization Measures.

Autor:	Brewster AL; Division of Health Policy and Management, University of California-Berkeley School of Public Health, Berkeley, CA., Yuan CT; Armstrong Institute for Patient Safety and Quality, Johns Hopkins School of Medicine, Baltimore, MD., Tan AX; Department of Health Policy and Management, Yale School of Public Health, New Haven, CT., Tangoren CG; Department of Health Policy and Management, Yale School of Public Health, New Haven, CT., Curry LA; Department of Health Policy and Management, Yale School of Public Health, New Haven, CT.
Jazyk:	angličtina
Zdroj:	Medical care [Med Care] 2019 May; Vol. 57 (5), pp. 327-333.
DOI:	10.1097/MLR.0000000000001097
Abstrakt:	Background: Services targeting social determinants of health-such as income support, housing, and nutrition-have been shown to improve health outcomes and reduce health care costs for older adults. Nevertheless, evidence on the properties of effective collaborative networks across health care and social services sectors is limited. Objectives: The main objectives of this study were to identify features of collaborative networks of health care and social services organizations associated with avoidable health care use and spending for older adults. Research Design: Through a 2017 survey, we collected data on collaborative ties among health care and social service organizations in 20 US communities with either high or low performance on avoidable health care use and spending for Medicare beneficiaries. Six types of ties were measured: any collaboration, referrals, sharing information, cosponsoring projects, financial contracts, and joint needs assessment. We examined how characteristics of collaborative networks were associated with performance. Results: High-performing networks were distinguished from low-performing networks by 2 features: (1) health care organizations occupied positions of significantly greater centrality (P<0.01), and (2) subnetworks of cosponsorship ties were more cohesive, as measured by centralization (P=0.05) and density (P=0.06). Across all networks, Area Agencies on Aging were more centrally positioned than any other type of organization (P<0.05). Conclusions: Cross-sector engagement by health care organizations, particularly development of deeper types of collaborative ties such as cosponsorship, may reduce preventable health care use and spending. Efforts to foster effective partnerships could leverage the Area Agencies on Aging, which are already positioned as network brokers.
Databáze:	MEDLINE
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