Fragmented care and chronic illness patient outcomes: A systematic review.
Jee Young Joo
PMID 36622952WHAT IT FOUND
In US adults with chronic illnesses, fragmented care was associated with more emergency visits, more diagnostic tests, and higher costs; readmission and comorbidity findings were mixed.
Key findings
01Fragmented care was significantly related to emergency visits and diagnostic test use in four studies, and all studies examining costs reported higher costs.
02Hospital readmission findings were mixed.
03Comorbidity risk findings were mixed, with some studies reporting increased risk and another reporting no association with blood pressure or cholesterol control.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
All included studies were observational, so they can show association but not cause. The studies used different definitions and measures of fragmented care, and none used a theoretical framework. Findings were mixed for hospital readmission and comorbidity risk. The review included only US studies, so results may not apply to other health systems. The authors note possible reporting bias because the included studies tended to report significant relationships.
Declared interests
This research was supported by a National Research Foundation of Korea grant. The authors declared no conflict of interest.
The easy way to misread this
Do not conclude that fragmented care caused these outcomes, or that care coordination will reduce them. The included studies were observational, did not test an intervention, and had mixed readmission and comorbidity findings.