Patient Perspectives of Care Integration During Early Implementation of a Care Coordination Initiative.

Research shows care coordination contributes to integrated care experiences. Yet evidence from system-level initiatives is lacking. Using a survey of Veterans Health Administration (VHA) patients linked with clinical records, this nonrandomized, cross-sectional study compares perceived care integration among patients at high risk of hospitalization or mortality who did and did not receive care coordination services at 31 VHA sites during early implementation of a national initiative. Six validated dimensions included: knowledge about patient's medical history among staff, providers, and specialists; provider support for self-directed care and for medication adherence and home care; and test results communication. Among 714 respondents, 48% had received care coordination services, 78% were 65 or older, and 95% were male. Regression models suggest little association between receipt of care coordination and perceived care integration. Implementation monitoring followed by responsive adaptations may be needed to boost patient perceptions of care integration.