Better continuity of care for elderly pataients cuts costs and complications, study finds

March 17, 2014

Improving the coordination of care for elderly patients with chronic diseases trims costs, reduces use of health services and cuts complications, according to a new RAND Corporation study.

Studying a large group of Medicare patients, researchers found that even modest improvements in the continuity of care among patients with diabetes, or emphysema were associated with sizable reductions in use of hospital emergency departments and hospitalizations.

The findings, published online by JAMA Internal Medicine, suggest that improving the coordination of care for patients with these three illnesses could save Medicare as much as $1.5 billion per year.

"Improving the coordination of care for patients with can be difficult to achieve, but our findings suggest that it can have benefits for both patients and the system," said Peter Hussey, the study's lead author and a senior policy researcher at RAND, a nonprofit research organization.

Patients with chronic illnesses often face care that is poorly coordinated. They may see many different working in multiple clinical locations, and poor communication between provider and patient is common. These factors can lead to higher use of 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—encouraged under the Affordable Care Act—are intended to reduce costs and improve quality through better coordination of care.

Previous studies have shown that patients with a close, continuous relationship with a physician are more likely to received recommended medical care. But many programs that aim to improve coordination of care have not reduced costs or improved quality.

Researchers evaluated the care received by nearly 300,000 Medicare recipients who were treated for an episode of congestive heart failure, emphysema or type 2 diabetes.

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 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," Hussey said. "As and payment programs evolve, we need to measure whether these reforms improve continuity and reduce ."

Explore further: Medical homes make small improvement in quality, do not cut costs, study finds

Related Stories

Medical homes make small improvement in quality, do not cut costs, study finds

February 25, 2014
A three-year pilot of a "medical home" model of primary care yielded few improvements in the quality of care and no reductions in hospitalizations, emergency department visits or total costs of care, according to a new RAND ...

Study tracks factors linked to creation of accountable care organizations

October 7, 2013
Regions of the U.S. where doctors and hospitals are consolidated into large networks are more likely to have accountable care organizations, medical practice structures intended to improve medical care and cut costs, according ...

Lessons learned managing geriatric patients offer framework for improved care

March 11, 2014
A large team of experts led by a Johns Hopkins geriatrician reports that efforts to improve the care of older adults and others with complex medical needs will fall short unless public policymakers focus not only on preventing ...

Doctors who share patients may provide lower cost care

August 1, 2012
Patients with diabetes or congestive heart failure who receive care from doctors with high levels of patient overlap have lower total health care costs and lower rates of hospitalization, according to a new study in the Journal ...

Promise of value-based payments in health care remains unproven, study finds

March 4, 2014
After a decade of experimentation with reforms that give health providers financial incentives to improve performance, relatively little is known about how to best execute such strategies or judge their success, according ...

Determinants of patient loyalty to provider identified

December 16, 2013
(HealthDay)—Determinants of patient loyalty have been identified and include confidence in care provider and coordination of care, according to a report published by Press Ganey.

Recommended for you

Americans misinformed about smoking

August 22, 2017
After voluminous research studies, numerous lawsuits and millions of deaths linked to cigarettes, it might seem likely that Americans now properly understand the risks of smoking.

Women who sexually abuse children are just as harmful to their victims as male abusers

August 21, 2017
"That she might seduce a helpless child into sexplay is unthinkable, and even if she did so, what harm can be done without a penis?"

To reduce postoperative pain, consider sleep—and caffeine

August 18, 2017
Sleep is essential for good mental and physical health, and chronic insufficient sleep increases the risk for several chronic health problems.

Despite benefits, half of parents against later school start times

August 18, 2017
Leading pediatrics and sleep associations agree: Teens shouldn't start school so early.

Doctors exploring how to prescribe income security

August 18, 2017
Physicians at St. Michael's Hospital are studying how full-time income support workers hired by health-care clinics can help vulnerable patients or those living in poverty improve their finances and their health.

In a nutshell: Walnuts activate brain region involved in appetite control

August 17, 2017
Packed with nutrients linked to better health, walnuts are also thought to discourage overeating by promoting feelings of fullness. Now, in a new brain imaging study, researchers at Beth Israel Deaconess Medical Center (BIDMC) ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.