How do we know what’s in space?

Can you think of a plan to improve health outcomes and the quality of patients’ care without addressing the lack of coordination across health and care services? The growth of chronic illness and aging populations has placed a substantial burden on healthcare systems in both developed and developing countries. ¹ As a result, gaps within the systems are increasingly becoming apparent as is the cry for improved coordination of health and care services.

Although the need for care coordination is clear, what is less well understood is that care coordination is a complex strategy that comprises an essential mix of relational, structural and information elements. Moreover, care coordination is influenced by multiple factors: clinical factors, resources, individual views about entitlements, relationships and characteristics of the health system. ² For care coordination to be successful, patient’s needs and preferences should be known ahead of time, communicated at the right time to the right people, and this information should be used meaningfully by all those involved in care coordination. ³

In daily practice, however, care coordination too often gets shaped in a one-size-fits-all fashion. Yet, from two different reviews of studies about the effectiveness of care management programs for people with diabetes, it was found that only patients who have poor glycaemic control benefit from such programs.^4,5 Further, various existing evaluation studies of care coordination over-rely on methods and measures not addressing its complex nature. For example, effectiveness of care management programs often get measured in terms of clinical outcome and process measures only.^6,7 We are still discovering what care coordination is, how it needs to be developed, implemented and evaluated.

This issue adds to the body of knowledge about care coordination. Knai et al. ⁸ report about factors hindering the successful implementation of chronic care approaches in six European healthcare systems and also focus on processes to address these factors. Martyn and Davis ⁹ provide a policy analysis of current care provision for people with complex care needs in the United States of America and propose several options, from a cost–benefit and policy perspective, to improve health outcomes for people with complex care needs.

Sengers et al. ¹⁰ examined how departments of mental healthcare organisations coordinate dependencies between pathways, to discern types of coordination used and to construct a theoretical framework. A comprehensive research approach to study integrated care in Belgium is presented by Dessers et al. Their CORTEXS study consists of taxonomy development, literature review, comparative case studies, social lab activities and valorisation initiatives. ¹¹

The International Journal of Care Coordination (IJCC) welcomes articles from multidisciplinary fields providing the latest insights in care coordination, quality of care and healthcare innovation. The IJCC has presence on Twitter via @SAGENursing, @SAGEHealthInfo, and @BertVrijhoef by means of #IntCareCoord.