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High-Risk Patient Experiences Associated With an Intensive Primary Care Management Program in the Veterans Health
Linnaea Schuttner1, Rong Guo, Edwin Wong
1Health Systems Research & Development, VA Puget Sound Health Care System, Seattle, Washington (Drs Schuttner and Wong); Department of Medicine, University of Washington School of Medicine, Seattle (Dr Schuttner); VA Greater Los Angeles Healthcare System, Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP), Los Angeles, California (Ms Guo and Drs Jimenez and Chang); Division of General Internal Medicine, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles (Ms Guo and Drs Jimenez and Chang); Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle (Dr Wong); VA Northeast Ohio Healthcare System, Cleveland, and Case Western Reserve University School of Medicine, Cleveland, Ohio (Dr Klein); Salisbury W.G. Hefner VA Medical Center, Salisbury, North Carolina (Dr Roy); VA Center for Health Equity Research & Promotion, VA Pittsburgh Healthcare System, Pittsburgh, and Department of Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (Dr Rosland); and Division of General Internal Medicine, Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, California (Dr Chang).
Abstract:
Intensive management programs may improve health care experiences among high-risk and complex patients. We assessed patient experience among (1) prior enrollees (n = 59) of an intensive management program (2014-2018); (2) nonenrollees (n = 356) at program sites; and (3) nonprogram site patients (n = 728), using a patient survey based on the Consumer Assessment of Healthcare Providers and Systems in 2019. Outcomes included patient ratings of patient-centered care; overall health care experience; and satisfaction with their usual outpatient care provider. In multivariate models, enrollees were more satisfied with their current provider versus nonenrollees within program sites (adjusted odds ratio 2.36; 95% confidence interval 1.15-4.85).
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