Achieving Care Integration from the Patients’ Perspective: Results from a Care Management Program

Abstract

Integration of care is emerging as a central challenge of health care delivery particularly for older adults with multiple, complex chronic conditions. Recent health reform efforts encourage the integration of care delivery across providers. Yet, the ability of such programs to deliver integrated care has not been evaluated from the patient’s perspective. Using a novel survey instrument, we surveyed 3,000 patients with complex, chronic conditions from nine physician practices belonging to one large physician group in New England. Analyses compare perceptions of integrated care among patients in a specialized care management program to those receiving regular care. Our analyses suggest that a large number of patients experience relatively low levels of integrated care across many survey items, signifying additional work is needed for continued improvement in care integration. However, specific and targeted programmatic integration efforts can make a difference among patient perceptions of integrated care. Multivariate regression analyses confirmed original hypotheses that care management program patients will perceive their care to be more highly integrated in the survey domains for which the care management program was designed around: connecting the patient to home services and providing continuity of care outside of office visits.