The coalition process at work: Building care coordination models to control chronic disease

Area of Science:

• Public Health
• Health Systems Research
• Chronic Disease Management

Background:

• Asthma is a prevalent chronic disease with substantial morbidity.
• Fragmented care delivery negatively impacts patient outcomes.
• Patient-centered approaches and coordinated systems are crucial for improving asthma care.

Purpose of the Study:

• To evaluate the effectiveness of community coalitions in improving asthma care coordination.
• To identify common barriers and successful strategies employed by coalitions addressing system fragmentation.

Main Methods:

• Seven "Allies Against Asthma" coalitions utilized collaborative processes.
• Interventions were tailored to community-specific needs, assets, and stakeholders.
• Focus was on addressing system fragmentation and enhancing care coordination.

Main Results:

• Coalitions successfully identified and addressed issues of inefficient, inconsistent, and fragmented asthma care.
• Despite significant barriers (provider engagement, interinstitutional coordination, patient involvement, insurer interaction, system inertia), coordinated improvements were achieved.
• Diverse interventions were developed and implemented based on coalition-specific contexts.

Conclusions:

• Community coalitions can effectively drive coordinated improvements in asthma care systems.
• Collaborative efforts can overcome significant barriers to enhance patient-centered care delivery.
• Addressing system fragmentation through linked systems is a viable strategy for managing chronic diseases like asthma.