Survey of Patient-Centered Coordination of Care for Diabetes with Cardiovascular and Mental Health Comorbidities in the Department of Veterans Affairs.
J Gen Intern Med
; 34(Suppl 1): 43-49, 2019 05.
Article
em En
| MEDLINE
| ID: mdl-31098975
ABSTRACT
BACKGROUND:
Multiple comorbidities thought to be associated with poor coordination due to the need for shared treatment plans and active involvement of patients, among other factors. Cardiovascular and mental health comorbidities present potential coordination challenges relative to diabetes.OBJECTIVE:
To determine how cardiovascular and mental health comorbidities relate to patient-centered coordinated care in the Department of Veterans Affairs.DESIGN:
This observational study used a 2 × 2 factorial design to determine how cardiovascular and mental health comorbidities are associated with patient perceptions of coordinated care among patients with type 2 diabetes mellitus as a focal condition.PARTICIPANTS:
Five thousand eight hundred six patients attributed to 262 primary care providers, from a national sample of 29 medical centers, who had completed an online survey of patient-centered coordinated care in the Department of Veterans Affairs (VA). MAINMEASURES:
Eight dimensions from the Patient Perceptions of Integrated Care (PPIC) survey, a state-of-the-art measure of patients' perspective on coordinated and patient-centered care. KEYRESULTS:
Mental health conditions were associated with significantly lower patient experiences of coordinated care. Hypotheses for disease severity were not supported, with associations in the hypothesized direction for only one dimension.CONCLUSIONS:
Results suggest that VA may be adequately addressing coordination needs related to cardiovascular conditions, but more attention could be placed on coordination for mental health conditions. While specialized programs for more severe conditions (e.g., heart failure and serious mental illness) are important, coordination is also needed for more common, less severe conditions (e.g., hypertension, depression, anxiety). Strengthening coordination for common, less severe conditions is particularly important as VA develops alternative models (e.g., community care) that may negatively impact the degree to which care is coordinated.Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Doenças Cardiovasculares
/
Assistência Centrada no Paciente
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Continuidade da Assistência ao Paciente
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Diabetes Mellitus Tipo 2
/
Transtornos Mentais
Tipo de estudo:
Clinical_trials
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Diagnostic_studies
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Observational_studies
/
Prognostic_studies
Limite:
Aged
/
Female
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Humans
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Male
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
J Gen Intern Med
Assunto da revista:
MEDICINA INTERNA
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Estados Unidos