Patient-Reported Care Coordination: Associations With Primary Care Continuity and Specialty Care Use

The Article in Brief

Patient-Reported Care Coordination: Associations With Primary Care Continuity and Specialty Care Use

David T. Liss , and colleagues

Background There is a growing need to coordinate medical care between primary care clinicians and specialists, patients, payers, and professional organizations. This study investigates the association between primary care continuity (the concentration of visits to primary care clinicians) and coordination by primary care clinicians.

What This Study Found When elderly patients with chronic conditions receive large amounts of outpatient specialty care, the ability of primary care clinicians to coordinate care in the traditional office setting seems to diminish. Analyzing data on 2,051 Medicare enrollees with select chronic conditions, researchers find a positive association between continuity and coordination for patients with low levels of specialty care use, but not for patients who utilize specialty care at high levels.

Implications

• Coordinating care for an aging population with high levels of specialty care use entails additional work for primary care practices and strains their ability to effectively coordinate patient care.
• The authors call for new methods of care provision that preempt gaps in continuity and coordination that may result from high specialty use.