The Opportunity
Poorly coordinated care may lead to negative, unintended
consequences including medication errors and preventable hospital admissions.1, 2 The
Agency for Healthcare Research and Quality (AHRQ) estimates that adverse
medication events cause more than 770,000 injuries and deaths each year, more
than half of which affect those over age 65.3 The cost of treating patients harmed by these
events is estimated at $5 billion annually.4 For example, individuals with chronic
conditions whose care relies on effective coordination through a complex
healthcare system, managed by multiple providers in multiple settings, often
find it difficult to navigate the system of care. For these individuals, the
difficulty in managing these multiple care transitions can contribute to poor outcomes
and hospitalizations. In 2010, preventable hospital admissions accounted for
nearly $32 billion of costs for adults with selected chronic and acute
diseases.5 The
coordination of care is essential to reduce preventable hospitalizations,
improve patient outcomes, and lower costs in today’s healthcare system.
A variety of tools and approaches, when leveraged, can
improve care coordination. For instance, care coordination is positively
associated with patient- and family-reported receipt of family-centered care,
resulting in greater satisfaction with services, lower financial burden, and
fewer emergency department visits.6 Additionally,
electronic health records (EHRs) can reduce unnecessary and costly duplication
of patient services.7 Patient education and the reconciliation of medication lists could also
reduce costs by decreasing the number of serious medication events.8 The Institute of Medicine (IOM) indicates that
care coordination initiatives such as patient education and the development of
new provider payment models could result in an estimated $240 billion in
savings.9
NQF Related Work
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1 Schultz EM, Pineda N, Lonhart J, et al. A systematic
review of the care coordination measurement landscape. BMC Health Serv Res. 2013;13:119.
2
Vogeli C, Shields AE, Lee TA, et al. Multiple chronic conditions: prevalence,
health consequences, and implications for quality, care management, and costs. J
Gen Intern Med. 2007;22 (Suppl 3):391-395.
3
Budnitz DS, Pollock DA, Weidenbach KN, et al. National surveillance of
emergency department visits for outpatient adverse drug events. JAMA.
2006;296(15):1858-1866.
4
AHRQ. Reducing and Preventing Adverse Drug Events to Decrease Hospital Costs.
Rockville, MD: AHRQ; 2001. Research in Action Pub No. #01-0020. Available at http://www.ahrq.gov/qual/aderia/aderia.html. Last
accessed March 2017.
5
Torio CM, Elixhauser A, Andrews RM. Trends in Potentially Preventable
Admissions among Adults and Children, 2005-2010. Rockville, MD:
AHRQ; 2013.
6
Turchi RM, Antonelli RC, Norwood KW Jr, et al. Patient-and family-centered care
coordination: a framework for integrating care for children and youth across
multiple systems. Pediatrics. 2014; 133(5):e1451-e1460.
7
Congressional Budget Office (CBO). Evidence on the Costs and Benefits of Health
Information Technology. Washington, DC: CBO; 2008. Available at http://www.cbo.gov/sites/default/files/cbofiles/ftpdocs/91xx/doc9168/05-20-healthit.pdf.
Last accessed March 2017.
8
Pronovost P, Weast B, Schwarz M, et al. Medication reconciliation: a practical
tool to reduce the risk of medication errors. J Crit Care.
2003;18(4):201-205.
9
Institute of Medicine (IOM). The Healthcare Imperative: Lowering Costs and
Improving Outcomes - Workshop Series Summary. Washington, DC: National
Academies Press; 2010.
