Influence of Cooperation Work on Management Continuity of Ambulatory Cardiovascular Care: A Cross-Sectional Exploratory Study in Germany.

Introduction: A wide range of factors influence coordination and continuity of care. The aim of this study was to explore how management continuity of cardiovascularrelated ambulatory care is influenced by the following network characteristics: presence of a case coordinator, network reciprocity, network composition and team climate. Methods: This cross-sectional observational study included three written surveys. The primary outcome management continuity of cardiovascular care was measured with the team/cross-boundary scale in the Nijmegen Continuity Questionnaire. The final analysis comprised a multivariate linear multilevel model with the predictors: presence of a case coordinator, network reciprocity, network composition and team climate. Results: Eighteen general practices with 83 health workers and 340 patients participated. The linear multilevel regression analysis showed a positive influence of team climate on cross-boundary continuity of care (b-coefficient 0.44, 95% confidence interval 0.09-0.78, p = 0.02). No statistically significant influence was measured for the other predictors. Discussion: To improve integrated care, therefore, emphasis should also be placed on promoting the team climate within individual practices. Regarding network characteristics, further research is needed, especially in larger practices. Conclusion: This study showed that team climate had an independent, relevant and statistically significant association with cross-boundary continuity of cardiovascular ambulatory care. [ABSTRACT FROM AUTHOR]