Understanding care coordination for Veterans with complex care needs: protocol of a multiple-methods study to build...

Area of Science:

• Health Services Research
• Veterans Health
• Care Coordination

Background:

• Care coordination is vital for patients with complex health and social needs, yet evidence on core elements and standardized needs assessment is inconsistent.
• Fragmented care and communication challenges hinder optimal care delivery for these patients.
• The Veterans Health Administration (VA) is implementing initiatives to improve care coordination processes and services.

Purpose of the Study:

• To build evidence for designing and implementing effective care coordination practices within the VA.
• To enhance care integration and improve health and care outcomes for Veterans with complex care needs.

Main Methods:

• A prospective observational, multiple-methods study is being conducted.
• Aim 1: Analyze existing data to link care coordination services with health outcomes in Veterans.
• Aim 2: Survey Veterans on their experiences with care coordination and integration.
• Aim 3: Interview providers on their perceptions of current care coordination needs assessment tools and processes.

Main Results:

• The study will identify Veterans with complex care needs and assess the impact of care coordination services on their health outcomes.
• Veteran and provider perceptions of care coordination will be gathered to inform intervention development.
• Analysis of existing data will examine the relationship between care coordination services and health outcomes.

Conclusions:

• The study will inform the development of an enhanced care coordination intervention.
• The goal is to improve care and health outcomes for Veterans facing complex health and social needs.