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Primary care team communication networks, team climate, quality of care, and medical costs for patients with diabetes: A cross-sectional study

Mundt, MP, Agneessens, F, Tuan, W-J, Zakletskaia, LI, Kamnetz, SA and Gilchrist, VJ (2016) Primary care team communication networks, team climate, quality of care, and medical costs for patients with diabetes: A cross-sectional study International Journal of Nursing Studies, 58. pp. 1-11.

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Abstract

Background: Primary care teams play an important role in providing the best quality of care to patients with diabetes. Little evidence is available on how team communication networks and team climate contribute to high quality diabetes care. Objective: To determine whether primary care team communication and team climate are associated with health outcomes, health care utilization, and associated costs for patients with diabetes. Methods: A cross-sectional survey of primary care team members collected information on frequency of communication with other care team members about patient care and on team climate. Patient outcomes (glycemic, cholesterol, and blood pressure control, urgent care visits, emergency department visits, hospital visit days, medical costs) in the past 12 months for team diabetes patient panels were extracted from the electronic health record. The data were analyzed using nested (clinic/team/patient) generalized linear mixed modeling. Participants: 155 health professionals at 6 U.S. primary care clinics participated from May through December 2013. Results: Primary care teams with a greater number of daily face-to-face communication ties among team members were associated with 52% (rate ratio = 0.48, 95% CI: 0.22, 0.94) fewer hospital days and US$1220 (95% CI: US$2416, US$24) lower health-care costs per team diabetes patient in the past 12 months. In contrast, for each additional registered nurse (RN) who reported frequent daily face-to-face communication about patient care with the primary care practitioner (PCP), team diabetes patients had less-controlled HbA1c (Odds ratio = 0.83, 95% CI: 0.66, 0.99), increased hospital days (RR = 1.57, 95% CI: 1.10, 2.03), and higher healthcare costs (b = US$877, 95% CI: US$42, US$1713). Shared team vision, a measure of team climate, significantly mediated the relationship between team communication and patient outcomes.

Item Type: Article
Subjects : subj_Management
Authors :
AuthorsEmailORCID
Mundt, MPUNSPECIFIEDUNSPECIFIED
Agneessens, FUNSPECIFIEDUNSPECIFIED
Tuan, W-JUNSPECIFIEDUNSPECIFIED
Zakletskaia, LIUNSPECIFIEDUNSPECIFIED
Kamnetz, SAUNSPECIFIEDUNSPECIFIED
Gilchrist, VJUNSPECIFIEDUNSPECIFIED
Date : 2016
Identification Number : 10.1016/j.ijnurstu.2016.01.013
Copyright Disclaimer : 2016 Elsevier Ltd. All rights reserved.
Depositing User : Symplectic Elements
Date Deposited : 04 May 2016 15:11
Last Modified : 20 May 2016 08:29
URI: http://epubs.surrey.ac.uk/id/eprint/810628

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