Experiences with care co-ordination among people with cerebral palsy, multiple sclerosis, or spinal cord injury.
OBJECTIVE
To describe the experiences with care co-ordination of people with cerebral palsy, multiple sclerosis, or spinal cord injury; to determine barriers to effective care co-ordination; and to compare experiences across disability and health plan types.


METHODS
Qualitative, semi-structured telephone interviews with 30 people with cerebral palsy, multiple sclerosis, or spinal cord injury. Interviews focused on the care co-ordination experience of individuals in managed care and traditional indemnity health insurance plans in the USA and were analysed using NVivo.


RESULTS
Half of the respondents reported that they had a health professional who co-ordinated their care. Participants identified barriers that prevented effective care co-ordination, including a lack of disability specific knowledge, providers' limited time and effort related to care, and insufficient communication among providers. There were few differences between managed care and fee-for-service respondents with regard to these barriers.


CONCLUSIONS
Study findings reveal few differences in the care co-ordination experiences amongst people with cerebral palsy, multiple sclerosis, or spinal cord injury in both plan types. All providers need to become more literate about the health care needs of people with physical disabilities, and health plans need to reward communication among providers and the time and effort invested in care co-ordination.
Kroll
Thilo
T
NRH Center for Health and Disability Research, Washington, DC 20036-5750, USA. Thilo.Kroll@Medstar.net
Neri
Melinda T
MT
D000328:Adult; D002547:Cerebral Palsy / Q000534:rehabilitation*; D003266:Continuity of Patient Care / Q000458:organization & administration*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008297:Male; D009103:Multiple Sclerosis / Q000534:rehabilitation*; D017060:Patient Satisfaction; D013119:Spinal Cord Injuries / Q000534:rehabilitation*; D014481:United States