The other day, I went to see my doctor for some tests. As I was sitting in the waiting room, I heard the nurse on the phone trying to help someone find a rehab hospital to go to after an operation. After placing a number of calls, the nurse finally found placement, only to be told that the patient’s insurance company wasn’t on the facility’s list of ‘preferred’ providers. Eventually they found a place for the patient to go but at a great waste of time and expense.

This is a scenario being played out every day here in the US, the story of a frustrating and inefficient system. The question is: How can we simplify the challenge of having to be transferred from one type of care to another and create patient-centered care that is more coherent both within and across care settings and over time?

And it is not just a problem in the US health care system, as discussed in a recent report by the OECD entitled Improved Health System Performance Through Better Care Coordination. This is a comprehensive paper focusing on the issue of care coordination and including an overview of the issue, identification of four key areas for reform, and an overview of practices in three countries – the US, Germany and England.

Major findings include:

  • Interest in coordination of care issues is increasing
  • Targeted programmes appear to improve quality but evidence on cost-efficiency is inconclusive
  • Care coordination would be facilitated by better information transfer and wider use of ICT
  • New ambulatory care models need consideration
  • Care coordination may benefit from greater health-system integration

The OECD report didn’t mention NTOCC – the National Transitions of Care Coalition – probably because it is so new. NTOCC was formed in the US in 2006 with a mission of being an influential stakeholder in public awareness, education and health policy to focus on improvement of quality of transitional care. NTOCC is rapidly building a following among all sectors of health care and could be a good model for others. Is there anything like this happening in your area? If so, please share with us.

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