Care coordination to target patient complexity and reduce disparities in primary care
| Autor: | Matthew R. Vail, Arlene Michaels Miller, Michael Schoeny, Regina McClenton, Kathryn Swartwout |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Population health Social issues Risk Assessment Health Services Accessibility Young Adult 03 medical and health sciences Quadrant (abdomen) 0302 clinical medicine Surveys and Questionnaires medicine Humans 030212 general & internal medicine Healthcare Disparities Curriculum General Nursing Aged Data collection Primary Health Care 030504 nursing Health risk assessment Medicaid managed care Medicaid business.industry Public Health Environmental and Occupational Health Social complexity Middle Aged United States Cross-Sectional Studies Family medicine Female 0305 other medical science business |
| Zdroj: | Public Health Nursing. |
| ISSN: | 1525-1446 0737-1209 |
| Popis: | Objective The purpose of this study was to describe our Activation and Coordination Team (ACT) model for interprofessional care coordination in primary care and examine feasibility of using ACT medical and social complexity criteria to categorize patients into Quadrants that determine resource utilization. Research questions were: (a) Are there significant differences in demographic, medical, and social characteristics by Quadrant; (b) Do patients with combined high medical and social complexity differ from those with either high medical or social complexity; and (c) Is there an association between initial screening risk level and ACT Complexity Quadrant placement? Design Cross-sectional, descriptive. Sample Patients (N = 167) aged 18-65 enrolled in an urban Medicaid managed care network. Measurements Screening and comprehensive health risk assessment questionnaires and clinical data collection from electronic health records. Results Patient characteristics differed significantly by Quadrant. Combined medical and social complexity produced greater impact than additive effects. Patients who initially screened low risk nevertheless met ACT criteria for medical and/or social complexity. Conclusions Greater effects for individuals with medical and social issues are due to interactions among factors. Traditional screening may miss patients with complex needs who need care coordination. Care coordination skills should be incorporated into population health curricula. |
| Databáze: | OpenAIRE |
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