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Patient Sharing and Quality of Care

Measuring Outcomes of Care Coordination Using Claims Data

Datos Bibliográficos

ID9102903
AutoresCraig Evan Pollack (0000-0003-2464-6415, Johns Hopkins University, autor de correspondencia), Klaus W Lemke, K Lemke (0000-0001-6936-5946, Johns Hopkins University), Eric T Roberts (0000-0002-7439-0799, Johns Hopkins University), Eric Roberts (0000-0002-1379-7931), Jonathan P Weiner (0000-0002-8299-3995, Johns Hopkins University)
Año2015
Volumen53
Número4
Páginas317-323
Fecha de publicación2015-04-01
Peer ReviewedSí
Open AccessNo
TipoARTICLE
RevistaMedical Care (JOURNAL)
Identificadores de la revistaISSN: 0025-7079 • E-ISSN: 1537-1948
EditorialOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000000319
PMID25719430
PMCIDPMC4384684
OpenAlexW2320429836
IdiomaEN
Citas recibidas5
Referencias citadas19

BACKGROUND: With the goal of improving clinical efficiency and effectiveness, programs to enhance care coordination are a major focus of health care reform. OBJECTIVE: To examine whether "care density"--a claims-based measure of patient sharing by office-based physicians--is associated with measures of quality. Care density is a proxy measure that may reflect how frequently a patient's doctors collaborate. RESEARCH DESIGN: Cohort study using administrative databases from 3 large commercial insurance plans. SUBJECTS: A total of 1.7 million adult patients; 31,675 with congestive heart failure, 78,530 with chronic obstructive pulmonary disease, and 240,378 with diabetes. MEASURES: Care density was assessed in 2008. Prevention Quality Indicators (PQIs), 30-day readmissions, and Healthcare Effectiveness Data and Information Set quality indicators were measured in the following year. RESULTS: Among all patients, we found that patients with the highest care density density--indicating high levels of patient sharing among their office-based physicians--had significantly lower rates of adverse events measured as PQIs compared with patients with low-care density (odds ratio=0.88; 95% confidence interval, 0.85-0.92). A significant association between care density and PQIs was also observed for patients with diabetes mellitus but not congestive heart failure or chronic obstructive pulmonary disease. Diabetic patients with higher care density scores had significantly lower odds of 30-day readmissions (odds ratio=0.68, 95% confidence interval, 0.48-0.97). Significant associations were observed between care density and Healthcare Effectiveness Data and Information Set measures although not always in the expected direction. CONCLUSION: In some settings, patients whose doctors share more patients had lower odds of adverse events and 30-day readmissions

Cohort · Confidence interval · Health care · Heart failure · Intensive care medicine · Logistic regression · Odds · Odds ratio · Proxy (statistics) · Emergency Medicine · Healthcare Policy and Management · Healthcare Systems and Technology · Internal Medicine · Medicine · Patient Satisfaction in Healthcare

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Obras citantes distintas5
Citas por año0,63
Intervalo de citas2018 - 2026 (9)
Velocidad de citacióncurrent
Altamente citadoNo
Tipos de citaNeutras: 5
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