Primary care team communication networks, team climate, quality of care, and medical costs for patients with diabetes: A cross-sectional study
| Autor: | Filip Agneessens, Wen Jan Tuan, Sandra Kamnetz, Larissa I. Zakletskaia, Valerie J. Gilchrist, Marlon P. Mundt |
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| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Cross-sectional study Interprofessional Relations education Team climate Article Midwestern United States 03 medical and health sciences 0302 clinical medicine Ambulatory care Health care medicine Diabetes Mellitus Humans 030212 general & internal medicine General Nursing Primary nursing Quality of Health Care Social network Primary Health Care business.industry Nurse 030503 health policy & services Communication Diabetes Odds ratio Emergency department Health Care Costs Primary care Team nursing Cross-Sectional Studies Family medicine Workforce Team Female 0305 other medical science business |
| Popis: | Primary care teams play an important role in providing the best quality of care to patients with diabetes. Little evidence is available on how team communication networks and team climate contribute to high quality diabetes care.To determine whether primary care team communication and team climate are associated with health outcomes, health care utilization, and associated costs for patients with diabetes.A cross-sectional survey of primary care team members collected information on frequency of communication with other care team members about patient care and on team climate. Patient outcomes (glycemic, cholesterol, and blood pressure control, urgent care visits, emergency department visits, hospital visit days, medical costs) in the past 12 months for team diabetes patient panels were extracted from the electronic health record. The data were analyzed using nested (clinic/team/patient) generalized linear mixed modeling.155 health professionals at 6 U.S. primary care clinics participated from May through December 2013.Primary care teams with a greater number of daily face-to-face communication ties among team members were associated with 52% (rate ratio=0.48, 95% CI: 0.22, 0.94) fewer hospital days and US$1220 (95% CI: -US$2416, -US$24) lower health-care costs per team diabetes patient in the past 12 months. In contrast, for each additional registered nurse (RN) who reported frequent daily face-to-face communication about patient care with the primary care practitioner (PCP), team diabetes patients had less-controlled HbA1c (Odds ratio=0.83, 95% CI: 0.66, 0.99), increased hospital days (RR=1.57, 95% CI: 1.10, 2.03), and higher healthcare costs (β=US$877, 95% CI: US$42, US$1713). Shared team vision, a measure of team climate, significantly mediated the relationship between team communication and patient outcomes.Primary care teams which relied on frequent daily face-to-face communication among more team members, and had a single RN communicating patient care information to the PCP, had greater shared team vision, better patient outcomes, and lower medical costs for their diabetes patient panels. |
| Databáze: | OpenAIRE |
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