A study from the American Journal of Managed Care has found that care fragmentation can contribute to increased health care costs and more visits to the doctor — especially for patients with chronic diseases. The study’s authors hesitate to point to any single causing factor, but suggest that providers in a fragmented system fail to see the forest for the trees:
One possibility is that with multiple providers each heavily involved in a patient’s care, no single provider is able to ensure that the entirety of a patient’s clinical needs are taken into account, leading to gaps in care as important issues go unaddressed.
They also offer a potential reason for higher health care costs in a fragmented provider system:
The higher costs associated with fragmentation may be driven by unnecessary duplication of services, or additional testing that results as patients see more and more providers, consistent with the findings here that patients with higher fragmentation saw a greater number of different providers of a given specialty type. Given the relatively poor exchange of clinical data among providers, it is possible that each additional visit with a new provider led to more tests, especially as patients saw more specialists. Finally, it is possible that that differences in costs may have been driven by poor care coordination leading to more preventable hospitalizations.
This study, and others like it, underscore precisely how important effective care coordination is — especially for chronic disease management.