PS1-14: Coordination and Integration of Care for Chronically Ill: Meaning and Measurement

• Published in: Clinical medicine & research Vol. 8; no. 1; pp. 45 - 46
• Main Authors: Vrijhoef, H. J., Wagner, E. H
• Format: Journal Article
• Language: English
• Published: Marshfield Clinic 01-03-2010
• Subjects: SELECTED ABSTRACTS - HMORN 2009: Comparative Effectiveness
• ISSN: 1539-4182; 1554-6179
• DOI: 10.3121/cmr.8.1.45-c

Background:
Innovative strategies in chronic care delivery are welcomed as responses to a set of problems that are evident to some degree in all health care services. Uncoordinated or fragmented arrangements for the delivery of care are one example of such problems. Notwithstanding the theoretical conceptualization of coordination and integration, in practice variation exists in how these concepts are applied and measured and in their impact on care. Consequently, difficulties are experienced in deciding how to best resolve care fragmentation.
Methods:
An exploratory, qualitative design is used to make the phenomena understandable and identify the perceptions of experts in chronic care coordination and integration. A purposive sample of 20 experts from the U.S., Canada, Australia, and Europe is in-depth interviewed by telephone or face-to-face. An interview guide is being applied to initiate and guide the interview. Three central topics are addressed: care fragmentation, coordination and integration, measurement. Interviews are audio-recorded and transcribed with the consent of interviewees. A grounded theory approach is used to analyze the data. Approval for the study is received from the Center’s Human Subject Review Office.
Results:
Preliminary results indicate an urgent need to resolve care fragmentation, and concepts of coordination and integration of care being interrelated and partially overlapping. By identifying a plethora of factors and stakeholders involved, the complexity of resolving care fragmentation gets revealed. Diversity is reflected by the type of indicators being identified to measure the impact of coordination or integration on care.
Conclusions:
Final conclusions will be drawn after completion of the data analysis and available in April 2009. Support for this research was provided by The Commonwealth Fund. The views presented here are those of the authors and should not be attributed to The Commonwealth Fund or its directors, officers, or staff.