Expert Reccommendations for Coordinating Care of Older Adults Across Treatment Settings
Baltimore, MD - In what is believed to be the first interview-style qualitative study of its kind among health care providers in the trenches, a team led by a Johns Hopkins geriatrician has further documented barriers to better care of older adults as they are transferred from hospital to rehabilitation center to home, and too often back again.
Using comments and concerns drawn from in-depth interviews of 18 physicians and two home health care agency administrators — all experienced in trying to coordinate care of older adults — the researchers created a framework for evaluating what actions and programs might improve care. For example, they say, more attention should be given to preventing drug errors or missed doses of medicine, earlier and more frequent communications among health care providers at different sites, the elimination of discharge planning delays, and patient education.
Moreover, they caution that strategies already planned or in use to improve coordination, such as pay-for-performance targets and educational interventions, need further study to determine their value and any unintended consequences. Improving care transitions, for example, is a high priority in the Affordable Care Act of 2010, which established a pay-for-performance financial incentive program to motivate better coordination. The study results suggest, however, that health care providers are unclear about how these incentives will be designed and are concerned that the wrong outcomes or processes will be measured. Continue>
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