AI Article Synopsis
- Case managers in medical homes help coordinate care for complex patients, and this study aimed to evaluate how patient views of their performance relate to overall satisfaction and healthcare usage.
- A retrospective cohort study was conducted with health system patients in Pennsylvania who interacted with case managers and completed a satisfaction survey.
- Results revealed that patients who rated case manager performance as very good were significantly more satisfied with their care and had lower rates of emergency department visits, implying that positive perceptions of case managers could lead to better patient experiences and potentially reduce acute care needs.
Article Abstract
Background: Case managers are employed in medical homes to coordinate care for clinically complex patients.
Objective: To measure the association of patient perceptions of case manager performance with overall satisfaction and subsequent health care utilization.
Design: Retrospective cohort study.
Setting: Integrated health system in Pennsylvania.
Patients: Members of the health system-owned health plan who 1) received primary care in the health system's clinics, 2) were exposed to clinic-embedded case managers, and 3) completed a survey of satisfaction with care.
Measurements: Survey assessment of case manager performance and overall satisfaction with care and claims-based assessment of case manager performance and subsequent hospitalizations or emergency department visits. Survey measures were dichotomized into very good versus less than very good.
Results: A total of 1755 patients (44%) completed the survey and 1415 met study criteria. Survey respondents who reported very good ratings of case manager performance across all items had a higher probability of reporting very good overall satisfaction with care (92.2% vs. 62.5%; P < 0.001) and had a lower incidence of subsequent emergency department visits (incidence rate ratio, 0.79 [95% CI, 0.64 to 0.98]; P = 0.029) but not hospitalizations (incidence rate ratio, 0.92 [CI, 0.75 to 1.11]; P = 0.37) up to 2 years after the survey compared with survey respondents who reported less-than-very good case manager performance on 1 or more questions on the survey.
Limitations: Satisfaction data demonstrated substantial ceiling effects. Survey nonresponse may have introduced bias in the results.
Conclusion: Patients' favorable perceptions of case managers are associated with higher overall satisfaction with care and may lower risk for future acute care use.
Primary Funding Source: Robert Wood Johnson Foundation and the U.S. Department of Veterans Affairs.
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| http://dx.doi.org/10.7326/M13-3007 | DOI Listing |
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