Associations among claims-based care fragmentation, self-reported gaps in care coordination, and self-reported adverse events

Autor: Lisa M. Kern, Jennifer D. Lau, Mangala Rajan, J. David Rhodes, Lawrence P. Casalino, Lisandro D. Colantonio, Laura C. Pinheiro, Monika M. Safford
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: BMC Health Services Research, Vol 24, Iss 1, Pp 1-10 (2024)
Druh dokumentu: article
ISSN: 1472-6963
DOI: 10.1186/s12913-024-11440-y
Popis: Abstract Background Fragmentation of care (that is, the use of multiple ambulatory providers without a dominant provider) may increase the risk of gaps in communication among providers. However, it is unclear whether people with fragmented care (as measured in claims) perceive more gaps in communication among their providers. It is also unclear whether people who perceive gaps in communication experience them as clinically significant (that is, whether they experience adverse events that they attribute to poor coordination). Methods We conducted a longitudinal study using data from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, including a survey on perceptions of healthcare (2017–2018) and linked fee-for-service Medicare claims (for the 12 months prior to the survey) (N = 4,296). We estimated correlation coefficients to determine associations between claims-based and self-reported numbers of ambulatory visits and ambulatory providers. We then used logistic regression to determine associations between claims-based fragmentation (measured with the reversed Bice-Boxerman Index [rBBI]) and self-reported gaps in care coordination and, separately, between claims-based fragmentation and self-reported adverse events that the respondent attributed to poor coordination. Results The correlation coefficient between claims-based and self-report was 0.37 for the number of visits and 0.38 for the number of providers (p
Databáze: Directory of Open Access Journals
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