Does clinical coordination improve quality and save money?

There is growing evidence that lack of coordination is the most common indirect or contributing cause of poor-quality outcomes. This review of research presents evidence of the costs of under-coordination, the effectiveness and cost of interventions to improve coordination, and evidence of savings or losses to different parties. It also presents an analysis of the implications of the evidence for different parties and for future research.

Many changes for better care coordination have not been well evaluated, so it is important to consider promising as well as proven changes. Also, a change found to have little effect in one place may work somewhere else. The lack of evidence does not mean that a change might not save money and raise quality, so promising and proven changes to coordination need local testing as part of implementation.

There is also evidence that better coordination combined with other changes can save money and raise quality for particular patients. These include: some methods for improving patient handover and transfers, and some models of care to prevent hospital admissions (for example, some disease management, case management, and multidisciplinary team-based approaches) and other chronic care and illness prevention models. The most cost-effective are those which identify and target the patients most likely to benefit.

http://www.doctorsandmanagers.com/adjuntos/299.1-does_clinical.pdf