Journal article
Evaluation of a patient-reported continuity of care model for older adults
Quality of life research, Vol.23(1), pp.185-193
02/01/2014
DOI: 10.1007/s11136-013-0472-z
PMID: 23868458
Abstract
Although continuity of care (CoC) is a cornerstone of many health policies, there is no theoretically driven model of CoC that incorporates the experiences of older adults. We evaluated such a model in data collected for another purpose.
We used data on 2,620 Medicare beneficiaries who completed all of the necessary components of the 2004 National Health and Health Services Use Questionnaire (NHHSUQ). The NHHSUQ solicited information on usual primary provider, place of care, and the quality and duration of the patient-provider relationship. We used confirmatory factor analysis to evaluate the patient-reported CoC model and examined factorial invariance across sex, race/ethnicity, Medicare plan type, and perceived health status.
Our thirteen-item CoC model consisted of longitudinal (care site and provider duration) and interpersonal (instrumental and affective) domains. Although the overall chi-square goodness-of-fit statistic was significant (chi (2) = 1,091.8, df = 57, p < .001), model fit was good based on standard indices (GFI = 0.94, NFI = 0.96, CFI = 0.96, RMSEA = 0.08). Cronbach's alpha for the longitudinal care site (two items) and provider duration (three items) scales was 0.88 and 0.75, respectively, while the instrumental and affective relationship scales (four items each) were 0.88 and 0.87, respectively. Factorial invariance between sexes was observed, with relatively minor variance across race/ethnicity, Medicare plan type, and perceived health.
We evaluated a theoretically derived model of CoC in older adults and found that the assessment of CoC should include the patient experience of both the longitudinal and the interpersonal dimensions of CoC.
Details
- Title: Subtitle
- Evaluation of a patient-reported continuity of care model for older adults
- Creators
- Suzanne E. Bentler - University of IowaRobert O. Morgan - The University of Texas at AustinBeth A. Virnig - University of MinnesotaFredric D. Wolinsky - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Quality of life research, Vol.23(1), pp.185-193
- Publisher
- Springer Nature
- DOI
- 10.1007/s11136-013-0472-z
- PMID
- 23868458
- ISSN
- 0962-9343
- eISSN
- 1573-2649
- Number of pages
- 9
- Grant note
- University of Iowa John W. Colloton Chair Alvin R. Tarlov and John E. Ware Jr. Doctoral Dissertation Award
- Language
- English
- Date published
- 02/01/2014
- Academic Unit
- Health Management and Policy; College of Public Health
- Record Identifier
- 9984364422502771
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