ArticleHealth services research2019
Exploring the association of care fragmentation and patient ratings of care quality: A mediation analysis of women Veterans' experience with VA care.
Article in Health services research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- An Evidence Map of the Women Veterans' Health Literature, 2016 to 2023: A Systematic Review.JAMA network open · 2025Pooled it
- Outpatient Care Fragmentation and Patient Satisfaction With Care.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2026Article
- Women veterans' experiences of veteran-specific support services: an international scoping review.BMC women's health · 2026Article
- "We don't get that information right back to us unless it's a full-blown cancer": Challenges coordinating lung cancer screening across healthcare systems.Health services research · 2025Article
- Electronic Consultations for Endocrine Conditions: A Scoping Review.Journal of the Endocrine Society · 2024Article
- Changes in Health Care Utilization During the First 2 Years of Massachusetts Medicaid Accountable Care Organizations.Population health management · 2023Article
- Jumping Through Hoops: Community Care Clinician and Staff Experiences Providing Primary Care to Rural Veterans.Journal of general internal medicine · 2023Article
- Quality Perceptions and Choice of Public Health Facilities: A Mediation Effect Analysis of Outpatient Experience in Rural China.Patient preference and adherence · 2022Article
- Optimal staffing in community health centers to improve quality of care.Health services research · 2021Article
- Exploring the association of care fragmentation and patient ratings of care quality: A mediation analysis of women Veterans' experience with VA care.Health services research · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveTo examine the relationship between care fragmentation and patient ratings of care quality and identify potentially actionable mediators. DATA SOURCES/STUDY
setting2015 telephone survey of 1395 women Veterans with three or more visits in primary care and/or women's health care in the prior year at 12 Veterans Affairs (VA) medical centers. STUDY
designCross-sectional analysis. DATA COLLECTION/EXTRACTION
methodsWe operationalized lower care fragmentation as receiving VA-only care versus dual use of VA/non-VA care. Participants rated VA care quality (overall care, women's health care (WH), and primary care (PC)) and three aspects of their patient experience (ease of access to services, provider communication, and gender sensitivity of VA environments). We examined associations between care fragmentation and care ratings and applied the Karlson-Holm-Breen decomposition method to test for mediation by aspects of patients' experience. PRINCIPAL
findingsLower care fragmentation was associated with higher ratings of care quality (odds ratios [95% CI] for overall care: 1.57 [1.14;2.17]; WH: 1.65 [1.20;2.27]; PC: 1.41 [1.10;1.82]). Relationships were mediated by patient-rated provider communication and gender sensitivity (26-54 percent and 14-15 percent of total effects, respectively). Ease of access was associated with higher care ratings (odds ratios [95% CI] for overall care: 2.93 [2.25;3.81]; WH: 2.81 [2.15;3.68]; PC: 2.33 [1.63;3.33], in models with the three types of patient care experiences included), but did not mediate the association of care fragmentation and care ratings.
conclusionsPotential negative effects of care fragmentation on care quality ratings could be mitigated by attention to quality of patient-provider communication and gender sensitivity of VA environments.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.