Uncovering Four Types of Care Coordination in Primary Care.

Abstract

Background: Care coordination helps patients with complex needs, but heterogeneity in its implementation is not understood. Latent class analysis (LCA) was used to describe types of care coordination in primary care using data from The Minnesota Care Coordination Effectiveness Study (MNCARES), a large representative observational study of Minnesota clinics. We also explore whether program types are associated with clinic, community, or patient characteristics.

Methods: Primary care clinics with care coordination participating in MNCARES were included in this exploratory analysis. Care coordinators responded to survey items about their programs' approaches to addressing social and complex medical needs, communication, care coordination volume, and support and resources available for care coordination. LCA was used to identify and describe distinct types of care coordination using 42 survey items. Bivariate analysis compared types to clinic, community, and patient characteristics.

Results: Four types of care coordination emerged across 316 clinics: type 1 a well-supported social/medical approach, type 2 a high volume social/medical approach, type 3 a well-resourced complex medical needs approach, and type 4 an onsite low volume approach. Type 1 clinics were more likely to have medical and community service access and serve younger patients and those born outside the US. Type 4 clinics were more likely urban with less community service access and served older adults.

Conclusion: This novel LCA approach successfully identified 4 distinct types of care coordination used by participating clinics. These results will help researchers to learn which approaches to care coordination are most effective in which contexts and help clinics decide how to operationalize care coordination.