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Care Coordination in Type 2 Diabetic Patients

Care Coordination in Type 2 Diabetic Patients

Introduction: Gap

Despite type 2 diabetes (T2DM) being one of the critical health concerns, a gap in care coordination has exacerbated morbidity and mortality rates related to the disease. Poor care coordination among the care professionals has been realized, especially for older diabetic patients who report complex care needs. While home-based care has been designed to address their care issues by delegating community care workers (CHW) to occasionally visit the patients and assist them to manage their healthcare condition, the lack of care coordination has been a critical barrier. Of note, there is poor interoperability of healthcare technology, implying that patient health information is rarely shared between their primary care provider and the CHW. Rawlins et al. (2017) report that low-quality care has been realized due to the low use of healthcare services for the older diabetic population. Therefore, the gap in care coordination involving sharing of health information should be addressed to improve care quality.

Introduction: History

Chang et al. (2018) report that CHW has been integral in improving care access and utilization among patients suffering from chronic conditions including diabetes. However, the involvement of CHW in diabetes management is not historical, but rather a modern issue. The increasing incidence of diabetes mellitus has called for the need to integrate CHW to assist the patients with health promotion activities such as lifestyle changes to improve their glycemic control. Nonetheless, the lack of interoperability of electronic health records to facilitate sharing of health information between the primary care provider and the CHW present a key issue that has affected the delivery of quality care to diabetic patients.

Introduction: Socioeconomic Background

While care coordination is critical in delivering patient-centered care, Weaver et al. (2018) highlight socioeconomic factors such as the level of education, income, and health literacy levels have been key to healthcare access among older diabetic patients. Several strategies including evidence-based models have been suggested to improve care access among disadvantaged populations such as the uninsured, to address quality and healthcare outcomes. Specifically, issues such as low health literacy levels have been a barrier to care access among the patients. For instance, patients with low educational attainment have been disadvantaged in terms of care access.

Introduction: Affect

Failing to address the gap in care coordination for older diabetic patients could lead to the delivery of low-quality care to such patients. Specifically, the lack of health information access may affect care delivery by the CHW. The patient’s health information usually describes their clinical profile and proves critical when addressing their safety (McLendon et al., 2019). The lack of access to such information by the community healthcare workers could lead to the implementation of intervention strategies that do not align with the patient’s safety profile, thereby affecting quality care delivery. Of note, McLendon et al. (2019) also report an increasing prevalence, mortality, morbidity, and societal costs of diabetic management arising due to poor care coordination. Neglecting the gap in care coordination may also affect patient clinical outcomes due to poor integration of evidence-based practice.

Introduction: Implications

Insufficient care coordination could influence the perception of care delivery in the long term. With the increasing incidence rates of chronic illnesses such as diabetes and hypertension, new dimensions in the healthcare delivery landscape have been unveiled, with the integration of interprofessional teams and involving CHW being pivotal, Still, CHW cannot be actively involved in care delivery when they have poor access to patient health information from the primary care provider. Therefore, care interoperability will need to be addressed to improve the quality of home-based care for older diabetic patients.

References

Chang, A., Patberg, E., Cueto, V., Li, H., Singh, B., Kenya, S., ... & Carrasquillo, O. (2018). Community health workers, access to care, and service utilization among Florida Latinos: A randomized controlled trial. American journal of public health, 108(9), 1249-1251.

McLendon, S. F., Wood, F. G., & Stanley, N. (2019). Enhancing diabetes care through care coordination, telemedicine, and education: Evaluation of a rural pilot program. Public Health Nursing, 36(3), 310-320.

Rawlins, W. S., Toscano-Garand, M. A., & Graham, G. (2017). Diabetes management with a care coordinator improves glucose control in African Americans and Hispanics. Journal of education and health promotion, 6.

Weaver, S. J., Che, X. X., Petersen, L. A., & Hysong, S. J. (2018). Unpacking care coordination through a multiteam system lens. Medical care, 56(3), 247-259.