Coordinated Health Care
In a recent article released by the Wall Street Journal’s Health Blog, it was noted that a study in JAMA (Journal of the American Medical Association) found that the newer theory of “coordinating care” just doesn’t save patients money. What is coordinating care? The WSJ article describes it this way: “Get a nurse or another health professional to keep track of treatments and doctor visits for patients with complex, chronic diseases such as diabetes or heart disease. The coordinator should communicate with doctors and help the patients keep on top of things like their drug regimens. Then the patients won’t end up with as many costly hospitalizations.”
Now that we know coordinating of care doesn’t reduce health care and insurance costs, are there other things that we should be taking into consideration here? Read on to see what this study looked at and what implications it has.
What Did the Coordinating Care Study Look At?
When I first read the WSJ article, I was disappointing. How could such a seemingly simple idea, having one point person act as the center of a wheel of care for a patient, backfire so badly? It just didn’t seem to make sense to me. This is where reading the fine print really comes into play. The article does state that the study only looked at 15 random cases of coordinated care, and the link to the actual JAMA study outlines the same. 15 cases isn’t a number to turn up one’s nose at, but I don’t find that little a data pool particularly telling.
For a type of care that’s relatively new, what can we tell from just looking at 15 cases throughout a hugely populated country? The measures of this study were how many times the patient needed hospitalizing during the set time period (which I’m assuming correlates to cost), monthly Medicare expenses and care process indicators.
What this Health Care Scare Overlooks
Before those of you on Medicare start protectively clutching at your pocketbooks, or writing off coordinated care as a failure, let’s look into what wasn’t examined in the study.
As with most scientific studies, there are going to be variables. Between the control and coordinated care group, only two cases showed any difference in hospitalizations. And, according to the WSJ article, one of those saw more hospitalizations in the coordinated care group. Ok, so that data is what it is. But, how old were these people? Gender? What ailments were are they dealing with? How long have they had said ailments and how severe are they? If you have your most sickly and elderly patients in the coordinated care group, of course that data is going to be skewed. You can have one person coordinating care around the clock but the reality is, modern medicine can only get us so far.
Another thing that concerns me is: Why is money the bottom line here? Why is it the ultimate measurement of how well a health care system is working? I honestly don’t believe enough time has lapsed to really see the outcome of coordinated care at this point, but I’m also disheartned by the measurement method.
If health care and health insurance isn’t at the point where it is free for every American citizen, then of course we’re all going to be concerned about how much health care costs us. But to me, money isn’t the bottom line. Of course it’s important, but when looking at how successful a new care system is, wouldn’t it be better to look at things like patient satisfaction, patient health and physician/nurse involvement and enjoyment? These, to me, seem like better ways to look at how well a health care system is working, and once you determine a program is successful in that sense, then you can look at driving the costs further down to make them accessible to everyone.
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Tags: affordability, coordinated care, cost cutting, coverage, health care, insurance, jama, studies, wsj
