Survey: Quality Coordination Begins with Primary Care

Posted by Cam McClellan Teems

April 27, 2017 at 12:17 PM


Strong patient-physician relationships form the core of quality care coordination. But many people lack access to this type of care, even in high-income countries with strong healthcare systems. A recent survey conducted by The Commonwealth Fund found that out of a population sample from 11 high-income countries, 5.2% of all respondents reported poor care coordination. And in the United States, that percentage was nearly double, at 9.8%.

So, what fuels those numbers? According to the survey, respondents who had positive relationships with their primary care physicians (PCPs) were less likely to report negative experiences with coordinated care. In fact, one of the biggest challenges facing the industry is a shortage of PCPs. Many young physicians choose specialty work over primary care these days. When the lack of a primary physician is coupled with the fragmented nature of specialty care, it’s no wonder that many patients face issues accessing the right care at the right time.

primary care

The survey consisted of five yes-or-no questions about whether in the past two years respondents had:

  • Been unable to access test results or medical records
  • Received conflicting information
  • Undergone a seemingly unnecessary medical test
  • Visited a specialist that did not have basic medical information or test results from the patient’s PCP
  • Felt that, after seeing a specialist, their PCP was not informed

Answering “yes” to any one of these questions marked a significant gap in care; three out of five was evidence of “poor coordination.” A full 33% of respondents reported at least one gap in coordination (of which lack of information sharing is a prime culprit) along with the 5.2% who experienced poor coordination. Those patients were also far more likely to undergo hospitalizations or trips to the ER than those who had positive experiences.

It is interesting to note that patients with chronic conditions or those younger than 65 were more likely to experience poor care coordination. And insurance status is yet another indicator that points to a systemic issue concerning coordination quality, along with income level, household income and gender. For more specifics about this data, check out this graph of the study’s findings.

Overall, the survey results revealed that the majority of coordinated care experiences are positive. And that’s a good sign. It all starts with patient engagement – to circle back around, that’s often the most important role for PCPs. Getting patients actively involved in their own care centers treatment around the individual and drives improved outcomes. Yet it can be tough to foster any sort of meaningful relationships when physicians spend only ten minutes at a time in the examination room due to backlogs.

But that’s where care coordination begins. Simply having the right technology or framework is not enough. Patients are people first and foremost. Thus, positive treatment outcomes stem from treating the person first. When care gets complex, providers need to work together to ensure that no one slips through the cracks. Even if the number is as small as 5.2%, that is still far too many people suffering the consequences of a fragmented care system.

Topics: Navigation & Care Coordination

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