Better Care Coordination for Older Patients Reduces Medical Care, Costs and Complications

Improving the coordination of care for elderly patients with chronic diseases cuts health-care costs, reduces use of health services and decreases medical complications, according to a new study conducted by researchers at the RAND Corporation, a nonprofit research organization with headquarters in Santa Monica.

The researchers studied a large group of Medicare patients and found that even modest improvements in the continuity of care among patients with diabetes, congestive heart failure or emphysema were associated with significant reductions in use of hospital emergency departments and hospitalizations. Researchers evaluated the care received by nearly 300,000 Medicare recipients.

The study used a standard measure of continuity of care to determine how well patients’ care was coordinated among different health providers. Care was deemed to be better coordinated if patients saw fewer health providers or if visits were concentrated among fewer providers.

Researchers found that patients with better continuity of care were less likely to be hospitalized, less likely to visit hospital emergency departments, had lower rates of complications and had lower overall costs for their episodes of care.

“Our results suggest the potential importance of care continuity and underscore the potential benefits that can be achieved through programs that improve coordination,” said Peter Hussey, the study’s lead author and a senior policy researcher at RAND.

The researchers found that improving the coordination of care for patients with the three illnesses could save Medicare as much as $1.5 billion per year.

Patients with chronic illnesses may see many different health-care providers working in multiple clinical locations, and poor communication between provider and patient is common, say the researchers which can lead to higher use of health services and poorer outcomes.

Care coordination among providers has been identified as a priority by the Institute of Medicine and the National Priorities Partnership, a coalition of 52 national organizations working to improve the U.S. health-care system. New models of patient care and provider payment programs are encouraged under the Affordable Care Act and are intended to reduce costs and improve quality through better coordination of care.

The study was published online in JAMA Internal Medicine and funded by the Aetna Foundation and the National Cancer Institute.

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