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Open Access Highly Accessed Research article

A systematic review of the care coordination measurement landscape

Ellen M Schultz*, Noelle Pineda, Julia Lonhart, Sheryl M Davies and Kathryn M McDonald

Author Affiliations

Center for Health Policy & Center for Primary Care and Outcomes Research, Stanford University, Stanford, CA, USA

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BMC Health Services Research 2013, 13:119  doi:10.1186/1472-6963-13-119

Published: 28 March 2013

Abstract

Background

Care coordination has increasingly been recognized as an important aspect of high-quality health care delivery. Robust measures of coordination processes will be essential tools to evaluate, guide and support efforts to understand and improve coordination, yet little agreement exists among stakeholders about how to best measure care coordination. We aimed to review and characterize existing measures of care coordination processes and identify areas of high and low density to guide future measure development.

Methods

We conducted a systematic review of measures published in MEDLINE through April 2012 and identified from additional key sources and informants. We characterized included measures with respect to the aspects of coordination measured (domain), measurement perspective (patient/family, health care professional, system representative), applicable settings and patient populations (by age and condition), and data used (survey, chart review, administrative claims).

Results

Among the 96 included measure instruments, most relied on survey methods (88%) and measured aspects of communication (93%), in particular the transfer of information (81%). Few measured changing coordination needs (11%). Nearly half (49%) of instruments mapped to the patient/family perspective; 29% to the system representative and 27% to the health care professionals perspective. Few instruments were applicable to settings other than primary care (58%), inpatient facilities (25%), and outpatient specialty care (22%).

Conclusions

New measures are needed that evaluate changing coordination needs, coordination as perceived by health care professionals, coordination in the home health setting, and for patients at the end of life.

Keywords:
Care coordination; Quality measurement; Measure development; Systematic review