title: The coalition process at work: Building care coordination models to control chronic disease.
abstract: Asthma is a highly prevalent and frequently misunderstood chronic disease with significant morbidity. Integrating client services at the patient-centered level and using coalitions to build coordinated, linked systems to affect care may improve outcomes. All seven Allies Against Asthma coalitions identified inefficient, inconsistent, and/or fragmented care as issues for their communities. In response, the coalitions employed a collaborative process to identify and address problems related to system fragmentation and to improve coordination of care. Each coalition developed a variety of interventions related to its specific needs and assets, stakeholders, stage of coalition formation, and the dynamic structure of its community. Despite common barriers in forming alliances with busy providers and their staff, organizing administrative structures among interinstitutional cultures, enhancing patient and/or family involvement, interacting with multiple insurers, and contending with health system inertia, the coalitions demonstrated the ability to produce coordinated improvements to existing systems of care.
authors.affiliation: Philadelphia Allies Against Asthma (PAAA), Department of Family and Community Medicine at the Jefferson Medical College of Thomas Jefferson University in Philadelphia, Pennsylvania, USA.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Rosenthal
authors.forename: Frances D
authors.initials: FD
authors.lastname: Butterfoss
authors.forename: Linda Jo
authors.initials: LJ
authors.lastname: Doctor
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Gilmore
authors.forename: James W
authors.initials: JW
authors.lastname: Krieger
authors.forename: John R
authors.initials: JR
authors.lastname: Meurer
authors.forename: Ivonne
authors.initials: I
authors.lastname: Vega
mesh_terms: D001249:Asthma / Q000628:therapy*; D002908:Chronic Disease / Q000628:therapy; D019058:Community Networks / Q000458:organization & administration*; D017598:Efficiency, Organizational; D006801:Humans; D017146:Models, Organizational; D018511:Systems Integration; D014481:United States