A mixed methods study of the experience of older adults with multimorbidity in a Care Coordination Program

Abstract

IntroductionCare Coordination Programs are designed to streamline services for older adults with multimorbidity. The Triple Aim, a conceptual model for the design and evaluation of healthcare models, stipulates that a balance of three aims—reducing costs, improving population health, and improving patient experience—are needed for high-quality, value-based care. Research is beginning to show that coordinating care across the continuum of care reduces costs and improves the health of the multimorbid older adult population. Yet little is known about older adults’ experience of care and their overall assessment of interactions with healthcare providers across the length of time of these interactions in a Care Coordination Program.MethodsTo gain a deeper understanding of older adults’ experience with a Care Coordination Program, this concurrent mixed methods research study analyzed 201 older adults’ assessment of their chronic illness care using the Patient Assessment of Chronic Illness Care (PACIC+). A subset of 30 older adults also participated in a telephone interview to collect qualitative data.ResultsThe experience of older adults with multimorbidity in a Care Coordination Program was related to two factors: (1) professional actions and (2) professional attitudes. Actions that improved patients’ experience of care were communication, coordination, and addressing fundamental problems. Professional attitudes that improved their experience of care included being compassionate, knowledgeable and professional, mutually respectful, and positive and encouraging.DiscussionTo improve patient experience, Care Coordination Programs must design and measure their efforts related to the actions and the attitudes of their care team, especially primary care physicians and care coordinators.