Experiences of care coordination among older adults in the United States: Evidence from the Health and Retirement Study |
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| Affiliation: | 1. Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA;2. Research Center for Group Dynamics, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA;1. Maastricht University, Department of Family Medicine, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht, The Netherlands;2. Maastricht University, Department of Educational Development and Research, School of Health Professions Education, Faculty of Health, Medicine and Life Sciences, Maastricht, The Netherlands;3. RCSI University of Medicine and Health Sciences, Health Professions Education Centre, Dublin, Ireland;1. Department of Radiation Oncology, University Hospitals Leuven, Leuven, Belgium;2. Department of Palliative Care, University Hospitals Leuven, Belgium;3. LUCAS KU Leuven Centre for Care Research & Consultancy, Leuven, Belgium;4. Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium;5. Department of Oncology, KU Leuven, Leuven, Belgium;1. Psycho-Oncology Co-operative Research Group (PoCoG), Level 6 (North) Lifehouse (C36Z), School of Psychology, University of Sydney, Sydney 2006 Australia;2. School of Public Health, University of Sydney, 2006 Sydney, Australia;3. Cancer Theme, Garvan Institute of Medical Research, 384 Victoria St, Darlinghurst, NSW 2010, Australia;4. St Vincent’s Clinical School, University of NSW, Sydney, Australia;5. School of Psychology, University of Sydney, Sydney 2006, Australia;6. Psychosocial Research Group, Prince of Wales Clinical School, University of NSW, Sydney 2052, Australia;7. Dept of Medical Oncology, Prince of Wales Hospital, 320-346 Barker St, Randwick, NSW 2031, Australia;8. Newborn Screening, Ethics and Disability Studies, RTI International, Washington, DC, USA;1. University of Newcastle, Department of Rural Health, Tamworth, NSW 2340, Australia;2. Hunter New England Local Health District, Tamworth, NSW 2340, Australia;3. Rheumatology Practice, Tamworth, NSW 2340, Australia;1. University of Kansas School of Medicine, Department of Population Health, Kansas City, KS USA;2. University of Kansas School of Nursing, Kansas City, KS USA |
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| Abstract: | IntroductionThe goal of this study was to examine variation in patient experiences and perceptions of care coordination across sociodemographic and health factors.MethodsData come from the 2016 Health and Retirement Study (N = 1, 216). Three domains of coordination were assessed: 1) Perceptions (e.g., patient impressions of provider-provider communication), 2) Tangible supports (e.g., meeting with a care coordinator, being accompanied to appointments), and 3) Technical supports (e.g., use of a “patient portal”). Logistic regression was used to quantify the frequency of each domain and examine variation by racial minority status, socioeconomic status, and health status.ResultsApproximately 42% of older adults perceived poor care coordination, including 14.8% who reported receiving seemingly conflicting advice from different providers. Only one-third had ever met with a formal care coordinator, and 40% were occasionally accompanied to appointments. Although racial minorities were less likely to have access to technical supports, they were more likely to use them. Better perceived coordination was associated with higher care satisfaction (Odds Ratio: 1.43, 95% CI: 1.27–1.61).ConclusionsImportant gaps in care coordination remain for older adults.Practice implicationsProviders should consider assessing patient perceptions of care coordination to address these gaps in an equitable manner. |
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| Keywords: | Patient-centered care Care coordination Care management Disparities |
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