Managing Chronic Illness.
Models of care coordination can significantly improve health outcomes for older adults with chronic illnesses if they can engage participants. The purpose of this study was to examine the impact of nursing contact on the rate of participants' voluntary disenrollment from a care coordination program. In this retrospective cohort study using administrative data for 1,524 participants in the Health Quality Partners Medicare Care Coordination Demonstration Program, the rate of voluntary disenrollment was approximately 11%. A lower risk of voluntary disenrollment was associated with a greater proportion of in-person (vs. telephonic) nursing contact (Hazard Ratio [HR] 0.137, confidence interval [CI] [0.050, 0.376]). A higher risk of voluntary disenrollment was associated with lower continuity of nurses who provided care (HR 1.964, CI [1.724, 2.238]). Findings suggest that in-person nursing contact and care continuity may enhance enrollment of chronically ill older adults and, ultimately, the overall health and well-being of this population.
1 University of North Carolina at Chapel Hill, USA.
Mark
M
Toles
2 Villanova University, PA, USA.
Helene
H
Moriarty
3 Health Quality Partners, Doylestown, PA, USA.
Ken
K
Coburn
3 Health Quality Partners, Doylestown, PA, USA.
Sherry
S
Marcantonio
4 University of Pennsylvania, Philadelphia, USA.
Alexandra
A
Hanlon
4 University of Pennsylvania, Philadelphia, USA.
Elizabeth
E
Mauer
4 University of Pennsylvania, Philadelphia, USA.
Paige
P
Fisher
2 Villanova University, PA, USA.
Melissa
M
O'Connor
4 University of Pennsylvania, Philadelphia, USA.
Connie
C
Ulrich
4 University of Pennsylvania, Philadelphia, USA.
Mary D
MD
Naylor
D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000628:therapy*; D003266:Continuity of Patient Care; D019468:Disease Management; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008329:Managed Care Programs; D006278:Medicare; D015999:Multivariate Analysis; D009741:Nursing Staff, Hospital; D010358:Patient Participation / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D014481:United States
care coordination; nursing contact; participant enrollment