Do Primary Physicians Actually Manage Their Patients' Fee-for-Service Care?

Dietrich, Allen J.; Nelson, Eugene C.; Kirk, John W.; Zubkoff, Michael; O’Connor, Gerald T.

doi:10.1001/jama.1988.03720210035025

Cited by 10 publications

(4 citation statements)

References 10 publications

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“…The concept of care coordination has been defined as a provider’s recognition of information about a patient from one visit to another (Starfield et al, 1979) or as other providers’ awareness of the primary physician’s involvement (Fletcher et al, 1984). Care coordination implies that health care is provided or coordinated in advance by the primary physician of patients (Dietrich et al, 1988). Discussions of care coordination mostly focus on the primary care setting in early stages.…”

Section: A Conceptual Framework Of Care Continuity and Care Coordinationmentioning

confidence: 99%

Care Continuity and Care Coordination: A Preliminary Examination of Their Effects on Hospitalization

Chen

Cheng

2020

Med Care Res Rev

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Both care continuity and care coordination are important features of the health care system. However, little is known about the relationship between care continuity and care coordination, their effects on hospitalizations, and whether these effects vary across patients with various levels of comorbidity. This study employed a panel study design with a 3-year follow-up from 2007 to 2011 in Taiwan’s universal health coverage system. Patients aged 18 years or older who were newly diagnosed with diabetes in 2007 were included in the study. We found that the correlation between care continuity and care coordination was low. Patients with higher levels of care continuity or care coordination were less likely to experience hospitalization for diabetes-related conditions. Furthermore, both care continuity and care coordination showed stronger effects for patients with higher comorbidity scores. Improving care continuity and coordination for patients with multiple chronic conditions is the right direction for policymakers.

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Section: A Conceptual Framework Of Care Continuity and Care Coordinationmentioning

confidence: 99%

Care Continuity and Care Coordination: A Preliminary Examination of Their Effects on Hospitalization

Chen

Cheng

2020

Med Care Res Rev

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“…For example, primary care generalists can act as gatekeepers to help patients and insurers achieve the best value for what they spend (Man ning et al 1984;Eisenberg 1985;Martin et al 1989) and as case manag ers to compensate for the fragmented care generated by increasing specialization (Dietrich et al 1988). In addition, generalists must dem onstrate that they provide better personal medical care than sub specialists for common medical problems, especially those of moderate severity.…”

Section: The Arguments Consideredmentioning

confidence: 99%

The Case of the Disappearing Generalist: Does It Need to Be Solved?

Moore¹

1992

The Milbank Quarterly

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The proportion of generalist physicians in the United States has declined steadily over 50 years, bringing it to the lowest percentage of trained primary care physicians of any developed country; the trend toward subspecialization is accelerating. Many analysts believe this imbalance between generalists and subspecialists to be a major cause of America's high health care costs, heavy dependence on biotechnology, and consumer dissatisfaction. Others argue that sub-specialists can provide excellent primary care services, and the decrease in the number of generalists is not a problem. Three contrasting views on the implications of this trend state that today's generalists are an important and scarce resource that must be bolstered; that subspecialists can replace generalists as providers of primary care; and that the free market will determine the best manpower mix. A final view, on the marketplace option, posits that generalism will not recover until it creates a vital, and unique, role in handling the primary care challenges of the twenty-first century. These competing viewpoints are used to clarify assumptions underlying our major policy options in the arena of health manpower.

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“…[7] In the early years, the concept of care coordination focused on primary care settings. It was defined as a provider's recognition of information concerning a patient from one visit to another [24], other providers' awareness of the involvement of the primary care physician [3] and the advanced coordination of patient care by the primary care physician [25]. Later, care coordination began to be considered a multidimensional concept and to frequently include information transfers among providers [26,27], communication among providers [7,[26][27][28][29][30] and cooperation among providers to create a care plan for a patient [7,18,26,27].…”

Section: Introductionmentioning

confidence: 99%

Continuity of Care and Coordination of Care: Can they Be Differentiated?

Chen¹,

Chiang²,

Lin³

et al. 2023

Int J Integr Care

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Introduction: Both care continuity and coordination are considered essential elements of health care system. However, little is known about the relationship between care continuity and coordination. This study aimed to differentiate the concepts of care continuity and coordination by developing and testing the reliability and validity of the Combined Outpatient Care Continuity and Coordination Assessment (COCCCA) questionnaire under the universal coverage health care system in Taiwan from a patient perspective.Methods: Face-to-face interviews were conducted nationwide with communitydwelling older adults selected via stratified multistage systematic sampling with probability-proportional-to-size process. A total of 2,144 subjects completed the questionnaire, with a response rate of 44.67%. Results:The 16 items of the COCCCA questionnaire were identified via item analysis and principal component analysis (PCA). The PCA generated five dimensions: three continuity-oriented (interpersonal, information sharing and longitudinal between patients and physicians) and two coordination-oriented (information exchange and communication/cooperation among multiple physicians). The second-order confirmatory factor analysis supported the factor structure and indicated that distinct constructs of care continuity and coordination can be identified. Conclusion:The COCCCA instrument can differentiate the concepts of care continuity and care coordination and has been demonstrated to be valid and reliable in outpatient care settings from a patient perspective.

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Do Primary Physicians Actually Manage Their Patients' Fee-for-Service Care?

Cited by 10 publications

References 10 publications

Care Continuity and Care Coordination: A Preliminary Examination of Their Effects on Hospitalization

Care Continuity and Care Coordination: A Preliminary Examination of Their Effects on Hospitalization

The Case of the Disappearing Generalist: Does It Need to Be Solved?

Continuity of Care and Coordination of Care: Can they Be Differentiated?

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