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Building blocks for measuring care coordination with claims data.

ABSTRACT: Tools to measure care coordination are needed to evaluate federal, state, and private sector efforts encouraging coordination to improve health outcomes and contain costs. Administrative data are a rich source of data for studying the use of medical services, thus allowing for measurement of patient level, provider level, and system measures of care coordination. Based on a review the literature and input from an expert panel, this article describes 4 key components-building blocks-of care coordination and corresponding measures. These building blocks should have utility across clinical conditions. They may be used to test hypotheses about the impact of coordinated care on medication utilization, adherence to medications, and clinical outcomes.

SUBMITTER: Segal JB

PROVIDER: S-EPMC4532896 | biostudies-literature | 2014 Aug

REPOSITORIES: biostudies-literature

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Building blocks for measuring care coordination with claims data.

Segal Jodi B JB DuGoff Eva H EH

Population health management 20140307 4

Tools to measure care coordination are needed to evaluate federal, state, and private sector efforts encouraging coordination to improve health outcomes and contain costs. Administrative data are a rich source of data for studying the use of medical services, thus allowing for measurement of patient level, provider level, and system measures of care coordination. Based on a review the literature and input from an expert panel, this article describes 4 key components-building blocks-of care coord ...[more]

PMID: 24606582

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Project description:BackgroundNot all primary care clinics are prepared to implement care coordination services for chronic conditions, such as diabetes. Understanding true capacity to coordinate care is an important first-step toward establishing effective and efficient care coordination. Yet, we could identify no diabetes-specific instruments to systematically assess readiness and/or status of primary care clinics to engage in diabetes care coordination.ObjectiveThis report describes the development and initial validation of the Diabetes Care Coordination Readiness Assessment (DCCRA), which is intended to measure primary care clinic readiness to coordinate care for adult patients with diabetes.DesignThe instrument was developed through iterative item generation within a framework of five domains of care coordination: Organizational Capacity, Care Coordination, Clinical Management, Quality Improvement, and Technical Infrastructure.ParticipantsValidation data was collected on 39 primary care clinics.Main measuresContent validity, inter-rater reliability, internal consistency, and construct validity of the 49-item instrument were assessed.Key resultsInter-rater agreement indices per item ranged from 0.50 to 1.0. Cronbach's alpha of the entire instrument was 0.964, and for the five domain scales ranged from 0.688 to 0.961. Clinics with existing care coordinators were rated as more ready to support care coordination than clinics without care coordinators for the entire DCCRA and for each domain, supporting construct validity.ConclusionsAs providers increasingly attempt to adopt patient-centered approaches, introduction of the DCCRA is timely and appropriate for assisting clinics with identifying gaps in provision of care coordination services. The DCCRA's strengths include promising psychometric properties. A valid measure of diabetes care coordination readiness should be useful in diabetes program evaluation, assistance with quality improvement initiatives, and measurement of patient-centered care in research.

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Building blocks for measuring care coordination with claims data.

Publications

Building blocks for measuring care coordination with claims data.

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