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- Title
Patterns of Collaboration among Health Care and Social Services Providers in Communities with Lower Health Care Utilization and Costs.
- Authors
Brewster, Amanda L.; Brault, Marie A.; Tan, Annabel X.; Curry, Leslie A.; Bradley, Elizabeth H.
- Abstract
<bold>Objective: </bold>To understand how health care providers and social services providers coordinate their work in communities that achieve relatively low health care utilization and costs for older adults.<bold>Study Setting: </bold>Sixteen Hospital Service Areas (HSAs) in the United States.<bold>Study Design: </bold>We conducted a qualitative study of HSAs with performance in the top or bottom quartiles nationally across three key outcomes: ambulatory care sensitive hospitalizations, all-cause risk-standardized readmission rates, and average reimbursements per Medicare beneficiary. We selected 10 higher performing HSAs and six lower performing HSAs for inclusion in the study.<bold>Data Collection: </bold>To understand patterns of collaboration in each community, we conducted site visits and in-depth interviews with a total of 245 representatives of health care organizations, social service agencies, and local government bodies.<bold>Principal Findings: </bold>Organizations in higher performing communities regularly worked together to identify challenges faced by older adults in their areas and responded through collective action-in some cases, through relatively unstructured coalitions, and in other cases, through more hierarchical configurations. Further, hospitals in higher performing communities routinely matched patients with needed social services.<bold>Conclusions: </bold>The collaborative approaches used by higher performing communities, if spread, may be able to improve outcomes elsewhere.
- Subjects
UNITED States; OLDER people; MEDICAL care; SOCIAL services; MEDICAL care costs; OUTPATIENT medical care; ECONOMIC impact; MEDICARE; MEDICAL care cost statistics; CLINICAL medicine; COMPARATIVE studies; COOPERATIVENESS; RESEARCH methodology; MEDICAL cooperation; RESEARCH; RESEARCH funding; SOCIAL case work; QUALITATIVE research; EVALUATION research; KEY performance indicators (Management); PATIENT readmissions; PATIENTS' attitudes
- Publication
Health Services Research, 2018, Vol 53, p2892
- ISSN
0017-9124
- Publication type
journal article
- DOI
10.1111/1475-6773.12775