Monday, February 23, 2009

Yay or Nay: Does coordination of care work?

An interesting and somewhat shocking Wall Street Journal report cites research from the Journal of the American Medical Association that finds coordination of care is ineffective at containing health care costs.

The model generally involves nurses or other medical professionals serving as the linchpin between physicians, other service providers and patients -- with the belief that keeping everyone on the same page regarding patient care and education would result in lower costs from reducing duplicative efforts and reduced hospitalizations due to conflicting treatment regimens.

JAMA's study shows that in 15 random trials of care-coordination programs, only two -- yes, two -- showed significant differences in hospitalizations between those whose care was coordinated and a control group. Even worse, one of the two actually posted more hospitalizations. The dagger: none of the programs posted any savings.

Having devoted no small amount of ink in EBN to the effectiveness of the care coordination model, I was truly surprised to read this data. What about you? What is your view of care coordination? Is it effective -- yay or nay?

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