Outcomes of an Integrated Health Care and Community Provider Interprofessional Team
Author Information
Author(s): Drost Jennifer, Hughes Michelle, Fosnight Sue, Marchiano Joseph, Hazelett Susan, Gareri Michele, Chrzanowski Brandi
Primary Institution: Summa Health, Akron, Ohio, United States
Hypothesis
Effective care requires collaboration between medical and community-based providers to address complex interactions between medical illness and social determinants of health.
Conclusion
The collaborative interprofessional model of care led to improvements in health care utilization, falls, medication management, home safety, and behavioral health among older adults.
Supporting Evidence
- 81 consumers were presented to the CMIT team over a 1-year period.
- 44 consumers had 3-month follow-ups, representing 54% of those presented.
- At baseline, 23% had recent health care utilization episodes.
- 39% had concerns about falls and medications.
- 48% had home safety concerns.
- At follow-up, 5 consumers showed improved health care utilization.
Takeaway
This study shows that when doctors and community helpers work together, older people can get better care and feel safer at home.
Methodology
Care managers evaluated older adults and presented cases to a team of specialists to develop and implement care plans.
Limitations
Only 54% of consumers had 3-month follow-up data available.
Participant Demographics
Older adults with various health concerns.
Digital Object Identifier (DOI)
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