Impact of primary and specialty care integration via asynchronous communication.
Am J Manag Care
; 25(1): 26-31, 2019 01.
Article
em En
| MEDLINE
| ID: mdl-30667608
ABSTRACT
OBJECTIVES:
To describe and evaluate the impact of primary and specialty care integration via asynchronous communication at a large integrated healthcare system. STUDYDESIGN:
In January 2014, Geisinger's primary care providers (PCPs) were given access to an asynchronous communication tool, Ask-a-Doc (AAD), that enabled direct communication with specialists in 14 medical specialties and 5 surgical specialties. Internal data were collected to assess PCPs' acceptance and use of the tool, as well as satisfaction. Insurance claims data were obtained to assess the impact on healthcare utilization and cost.METHODS:
A retrospective analysis of health plan claims data was conducted among those patients who had at least 1 specialist visit with 1 of the participating specialties between January 2014 and December 2016. A set of difference-in-differences multivariate linear regression models with patient fixed effects was estimated, in which those who were not exposed to AAD served as the comparison group.RESULTS:
Acceptance and use of AAD among PCPs gradually increased over time but varied by specialty. AAD was associated with an approximately 14% reduction in total cost of care during the first month of follow-up and a 20% reduction (P <.001) during the second month. These reductions in cost of care appeared to be driven by reductions in emergency department visits and physician office visits.CONCLUSIONS:
Geisinger's AAD experience suggests that the integration of primary and specialty care via the use of a highly reliable and efficient asynchronous communication system can potentially lead to reductions in avoidable care and more efficient use of specialty care.
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Coleções:
01-internacional
Contexto em Saúde:
11_ODS3_cobertura_universal
/
1_ASSA2030
Base de dados:
MEDLINE
Assunto principal:
Atenção Primária à Saúde
/
Especialização
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Atitude do Pessoal de Saúde
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Aceitação pelo Paciente de Cuidados de Saúde
/
Troca de Informação em Saúde
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Aspecto:
Patient_preference
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Am J Manag Care
Ano de publicação:
2019
Tipo de documento:
Article