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The Primary-Specialty Care Interface in Chronic Diseases: Patient and Practice Characteristics Associated with Co-Management
- Source :
- Healthcare Policy | Politiques de Santé. 10:52-63
- Publication Year :
- 2014
- Publisher :
- Longwoods Publishing, 2014.
-
Abstract
- Objective Specialist physicians may act either as consultants or co-managers for patients with chronic diseases along with their primary healthcare (PHC) physician. We assessed factors associated with specialist involvement. Methods We used questionnaire and administrative data to measure co-management and patient and PHC practice characteristics in 702 primary care patients with common chronic diseases. Analysis included multilevel logistic regressions. Results In all, 27% of the participants were co-managed. Persons with more severe chronic diseases and lower health-related quality of life were more likely to be co-managed. Persons who were older, had a lower socioeconomic status, resided in rural regions and who were followed in a PHC practice with an advanced practice nurse were less likely to be co-managed. Discussion Co-management of patients with chronic diseases by a specialist is associated with higher clinical needs but demonstrates social inequalities. PHC practices more adapted to chronic care may help optimize specialist resources utilization.
- Subjects :
- Male
medicine.medical_specialty
Cross-sectional study
Specialty
Quality of life (healthcare)
Ambulatory care
Residence Characteristics
Surveys and Questionnaires
Health care
medicine
Humans
Disease management (health)
Referral and Consultation
Chronic care
Advanced Practice Nursing
Primary Health Care
business.industry
Quebec
Disease Management
medicine.disease
Comorbidity
Cross-Sectional Studies
Social Class
Family medicine
Chronic Disease
Quality of Life
Medicine
Female
business
Research Paper
Subjects
Details
- ISSN :
- 17156580
- Volume :
- 10
- Database :
- OpenAIRE
- Journal :
- Healthcare Policy | Politiques de Santé
- Accession number :
- edsair.doi.dedup.....f8d51022cf19ed2a5b3978907fc0e4c7