Association between care coordination tasks with non-VA community care and VA PCP burnout: an analysis of a national, cross-sectional survey

BMC Health Services Research

Danielle E. Rose¹  Michael R. McClean¹  Elizabeth M. Yano²  Paul G. Shekelle³  Susan E. Stockdale⁴  Eric A. Apaydin⁵  Karin M. Nelson⁶ 

[1] Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd., MC 152, Bldg. 206 Rm. 252, 90073, Los Angeles, CA, USA;Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd., MC 152, Bldg. 206 Rm. 252, 90073, Los Angeles, CA, USA;Department of Health Policy & Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA;Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA;Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd., MC 152, Bldg. 206 Rm. 252, 90073, Los Angeles, CA, USA;Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA;Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd., MC 152, Bldg. 206 Rm. 252, 90073, Los Angeles, CA, USA;Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA;Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd., MC 152, Bldg. 206 Rm. 252, 90073, Los Angeles, CA, USA;RAND Corporation, Santa Monica, CA, USA;Seattle-Denver Center of Innovation, VA Puget Sound Health Care System, Seattle, WA, USA;

关键词: Burnout;    Primary care;    Care coordination;    Healthcare workforce;   

DOI  :  10.1186/s12913-021-06769-7

来源: Springer

【 摘 要 】

BackgroundThe scope of care coordination in VA primary care increased with the launch of the Veterans Choice Act, which aimed to increase access through greater use of non-VA Community Care. These changes may have overburdened already busy providers with additional administrative tasks, contributing to provider burnout. Our objective was to understand the role of challenges with care coordination in burnout. We analyzed relationships between care coordination challenges with Community Care reported by VA primary care providers (PCPs) and VA PCP burnout.MethodsOur cross-sectional survey contained five questions about challenges with care coordination. We assessed whether care coordination challenges were associated with two measures of provider burnout, adjusted for provider and facility characteristics. Models were also adjusted for survey nonresponse and clustered by facility. Trainee and executive respondents were excluded. 1,543 PCPs in 129 VA facilities nationwide responded to our survey (13 % response rate).Results51 % of our sample reported some level of burnout overall, and 46 % reported feeling burned out at least once a week. PCPs were more likely to be burned out overall if they reported more than average challenges with care coordination (odds ratio [OR] 2.04, 95 % confidence interval [CI] 1.58 to 2.63). These challenges include managing patients with outside prescriptions or obtaining outside tests or records.ConclusionsVA primary care providers who reported greater than average care coordination challenges were more likely to be burned out. Interventions to improve care coordination could help improve VA provider experience.

【 授权许可】

CC BY