UC Led Research Finds Poor Primary Care Coordination Higher in U.S.
CINCINNATI—A data analysis study led by University of
Cincinnati researchers concluded that the United States lags behind
other western, developed nations in providing primary care
coordination. Poor primary care coordination, the researchers say,
leads to gaps that are associated with medical errors, more
follow-up appointments and unnecessary health care spending.
The study, "Minding the Gap: Factors Associated With Primary
Care Coordination of Adults in 11 Countries,” appears in the
March/April edition of the Annals of Family Medicine and is
currently available online.
Primary care coordination is defined in the study as the
deliberate organization of patient care activities and sharing
information among all of the participants concerned to achieve safe
and more effective care.
Per the study, patients were less likely to experience poor
primary care coordination if their primary care physician often or
always knew their medical history, spent sufficient time, involved
them, and explained things well.
"Interestingly, poor primary care coordination in the
U.S. was not correlated with patients' insurance status, health
status, sex, or household income, but was evident with patients who
were chronically ill or younger which indicates that a much larger
system-level issue may be the cause of poor care coordination in
the U.S.,” says Johnathan Penm, PhD, the study’s
principal investigator during his fellowship at UC’s James L.
Winkle College of Pharmacy.
Penm and fellow researchers at UC evaluated data from a 2013
Commonwealth Fund International Health Policy survey which asked
adult patients about their health care experiences. The respondents
were from Australia, Canada, France, Germany, the Netherlands, New
Zealand, Norway, Sweden, Switzerland, United Kingdom and the
According to the study, out of 13,958 respondents, the
overall rate of poor primary care coordination was 5.2 percent. The
individual U.S. rate, however, was 9.8 percent.
This study further confirms the critical role of
communication between patients and their primary care providers,
says Neil MacKinnon, PhD, dean of the Winkle College of Pharmacy
"All primary care practitioners—whether physicians,
nurses, pharmacists or other allied health professions—have a
responsibility to ensure that communication is open, meaningful and
addresses patient concerns,” says MacKinnon, noting that
effective primary care coordination has been shown to reduce
Implementing these programs, however, can prove challenging.
The researchers cite a shortage of primary care physicians, health
professional workloads, underfunding of primary care by
governments, fragmentation between sectors of health care, and the
burden of disease and risk profile of the population as mitigating
"While our country is divided on the next steps post the
Affordable Care Act, we should be united on the need to enhance and
strengthen primary care coordination,” says MacKinnon.
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