title: Care coordination for the chronically ill: understanding the patient's perspective.
abstract: OBJECTIVE
  To identify factors associated with perception of care coordination problems among chronically ill patients.
  
  
  METHODS
  Patient-level data were obtained from a random-digit dial telephone survey of adults with chronic conditions. The survey measured respondents' self-report of care coordination problems and level of patient activation, using the Patient Activation Measure (PAM-13). Logistic regression was used to assess association between respondents' self-report of care coordination problems and a set of patient characteristics.
  
  
  RESULTS
  Respondents in the highest activation stage had roughly 30-40 percent lower odds of reporting care coordination problems compared to those in the lowest stage (p < .01). Respondents with multiple chronic conditions were significantly more likely to report coordination problems than those with hypertension only. Respondents' race/ethnicity, employment, insurance status, income, and length of illness were not significantly associated with self-reported care coordination problems.
  
  
  CONCLUSIONS
  We conclude that patient activation and complexity of chronic illness are strongly associated with patients' self-report of care coordination problems. Developing targeted strategies to improve care coordination around these patient characteristics may be an effective way to address the issue.
authors.affiliation: Geisinger Center for Health Research, 100 N. Academy Ave. M.C. 44-00 Danville, PA 17822, USA. ddmaeng@geisinger.edu
authors.forename: Daniel D
authors.initials: DD
authors.lastname: Maeng
authors.forename: Grant R
authors.initials: GR
authors.lastname: Martsolf
authors.forename: Dennis P
authors.initials: DP
authors.lastname: Scanlon
authors.forename: Jon B
authors.initials: JB
authors.lastname: Christianson
mesh_terms: D000328:Adult; D000367:Age Factors; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000523:psychology / Q000628:therapy*; D003266:Continuity of Patient Care; D003625:Data Collection; D004522:Educational Status; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D061214:Patient Safety / Q000592:standards / Q000706:statistics & numerical data; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011787:Quality of Health Care / Q000592:standards / Q000706:statistics & numerical data; D012959:Socioeconomic Factors