Together Achieving More: Primary Care Team Communication and Alcohol-Related Healthcare Utilization and Costs

Background Identifying and engaging excessive alcohol users in primary care may be an effective way to improve patient health outcomes, reduce alcohol‐related acute care events, and lower costs. Little is known about what structures of primary care team communication are associated with alcohol‐rela...

Full description

Saved in:
Bibliographic Details
Published in:Alcoholism, clinical and experimental research clinical and experimental research, 2015-10, Vol.39 (10), p.2003-2015
Main Authors: Mundt, Marlon P., Zakletskaia, Larissa I., Shoham, David A., Tuan, Wen-Jan, Carayon, Pascale
Format: Article
Language:English
Subjects:
Alcohol
Alcoholism - economics
Alcoholism - prevention & control
Communication
Female
Health Care Costs - statistics & numerical data
Health Personnel - economics
Health Personnel - organization & administration
Humans
Male
Middle Aged
Patient Acceptance of Health Care - statistics & numerical data
Patient Care Team - economics
Primary Care
Primary Health Care - economics
Primary Health Care - organization & administration
Social Network
Team
Wisconsin
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background Identifying and engaging excessive alcohol users in primary care may be an effective way to improve patient health outcomes, reduce alcohol‐related acute care events, and lower costs. Little is known about what structures of primary care team communication are associated with alcohol‐related patient outcomes. Methods Using a sociometric survey of primary care clinic communication, this study evaluated the relation between team communication networks and alcohol‐related utilization of care and costs. Between May 2013 and December 2013, a total of 155 healthcare employees at 6 primary care clinics participated in a survey on team communication. Three‐level hierarchical modeling evaluated the link between connectedness within the care team and the number of alcohol‐related emergency department visits, hospital days, and associated medical care costs in the past 12 months for each team's primary care patient panel. Results Teams (n = 31) whose registered nurses displayed more strong (at least daily) face‐to‐face ties and strong (at least daily) electronic communication ties had 10% fewer alcohol‐related hospital days (rate ratio [RR] = 0.90; 95% confidence interval [CI]: 0.84, 0.97). Furthermore, in an average team size of 19, each additional team member with strong interaction ties across the whole team was associated with $1,030 (95% CI: −$1,819, −$241) lower alcohol‐related patient healthcare costs per 1,000 team patients in the past 12 months. Conversely, teams whose primary care practitioner (PCP) had more strong face‐to‐face communication ties and more weak (weekly or several times a week) electronic communication ties had 12% more alcohol‐related hospital days (RR = 1.12; 95% CI: 1.03, 1.23) and $1,428 (95% CI: $378, $2,478) higher alcohol‐related healthcare costs per 1,000 patients in the past 12 months. The analyses controlled for patient age, gender, insurance, and comorbidity diagnoses. Conclusions Excessive alcohol‐using patients may fair better if cared for by teams whose face‐to‐face and electronic communication networks include more team members and whose communication to the PCP has been streamlined to fewer team members.
ISSN:0145-6008
1530-0277
DOI:10.1111/acer.12831