RNSurveyPatient education and counseling2022

Experiences of care coordination among older adults in the United States: Evidence from the Health and Retirement Study.

Marisa R Eastman, Viktoryia A Kalesnikava, Briana Mezuk

PMID 35331572

WHAT IT FOUND

About 15% of older adults often felt confused or received conflicting advice, especially those with three or more conditions or racial minority status.

Only one-third had met a formal coordinator; portal access and use were linked to higher satisfaction.

Key findings

01About 15% of older adults often felt confused about managing their health or received seemingly conflicting advice from providers.

02Racial or ethnic minorities had higher odds of feeling confused (OR 1.80) and receiving conflicting advice (OR 1.79), and people with three or more conditions had higher odds of conflicting advice (OR 1.90).

03Perceptions of coordination (OR 1.43) and technical supports (OR 1.26) were associated with higher care satisfaction, but tangible supports were not (OR 0.99).

STILL TO COME

How it was doneWhat they foundWhat it means for RNs

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What it does not show

This analysis was cross-sectional, so it cannot show that care coordination supports caused better perceptions or satisfaction. Experiences were self-reported by patients, and the study had no data from providers or payers to check them. Respondents who had not received care in the prior two years were excluded, so the findings do not describe older adults who had no recent healthcare contact. Race and ethnicity categories were collapsed because some groups had small cell sizes, which limits detail about specific minority groups. The study did not measure clinical outcomes, only perceptions, supports, and satisfaction. It used a survey module within a national cohort, so associations may reflect unmeasured differences between patients who use supports and those who do not.

Declared interests

The study used publicly available data and was supported by NIH extramural research funding. The supplied text does not report author conflicts of interest.

The easy way to misread this

Do not conclude that meeting a nurse care coordinator, receiving family or friend support, or using a patient portal caused better care satisfaction. The study is cross-sectional and self-reported, it did not measure clinical outcomes, and tangible supports were not significantly associated with satisfaction.

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