Care coordination for the chronically ill: understanding the patient's perspective

Health Serv Res. 2012 Oct;47(5):1960-79. doi: 10.1111/j.1475-6773.2012.01405.x. Epub 2012 Mar 30.


Objective: To identify factors associated with perception of care coordination problems among chronically ill patients.

Methods: Patient-level data were obtained from a random-digit dial telephone survey of adults with chronic conditions. The survey measured respondents' self-report of care coordination problems and level of patient activation, using the Patient Activation Measure (PAM-13). Logistic regression was used to assess association between respondents' self-report of care coordination problems and a set of patient characteristics.

Results: Respondents in the highest activation stage had roughly 30-40 percent lower odds of reporting care coordination problems compared to those in the lowest stage (p < .01). Respondents with multiple chronic conditions were significantly more likely to report coordination problems than those with hypertension only. Respondents' race/ethnicity, employment, insurance status, income, and length of illness were not significantly associated with self-reported care coordination problems.

Conclusion: We conclude that patient activation and complexity of chronic illness are strongly associated with patients' self-report of care coordination problems. Developing targeted strategies to improve care coordination around these patient characteristics may be an effective way to address the issue.

MeSH terms

  • Adult
  • Age Factors
  • Aged, 80 and over
  • Chronic Disease / psychology
  • Chronic Disease / therapy*
  • Continuity of Patient Care*
  • Data Collection
  • Educational Status
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Patient Safety / standards
  • Patient Safety / statistics & numerical data
  • Patient Satisfaction* / statistics & numerical data
  • Quality of Health Care / standards
  • Quality of Health Care / statistics & numerical data
  • Socioeconomic Factors