Care Coordination for the Chronically Ill: Understanding the Patient's Perspective

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. Conclusion 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.