The Associations between Having a Care Coordinator, Care Satisfaction, and Quality of Care Among Older Adults

Background and Purpose: The role of the care coordinator has emerged to address the complex U.S. healthcare systems by promoting communication across providers and navigation between medical systems. Nurses, social workers, and other healthcare professionals are most frequently employed as care coordinators. However, many family caregivers also serve as care coordinators to improve older adults’ quality of care. Previous care coordination studies have predominantly focused on nurses. Very few studies examine family care coordinators. Therefore, the current study examined whether having a care coordinator and the type of care coordinator (professional care coordinator, family care coordinator, both) are associated with care satisfaction and quality of care among older adults. This study also examined whether level of care coordinator’s involvement is associated with care satisfaction and perceptions of quality of care among older adults with professional care coordinators.

Methods: We utilized data from the 2016 wave of the Health and Retirement Study. We identified 1631 older adults who completed the Coordinated Care Module. Types of care coordinators included family care coordinators, professional care coordinators, and both. Care satisfaction is proxied by a single question asking level of satisfaction with care. The quality of care is measured by three variables, which assessed participants’ self-reports of (1) receiving conflicting advice from different healthcare providers, (2) feeling confused about managing health and (3) receiving person-centered care. Level of care coordinator’s involvement was measured by a question asking participants who have professional care coordinators to what extend coordinator involved in coordinating care. Multivariate regression was applied to determine the effects of care coordinator on care satisfaction and perceptions of quality of care.

Results: The findings suggest that receiving care from both professional and family care coordinators was associated with higher scores in receiving conflicting advice (β=0.35, p < 0.01) and being confused about managing health (β = 0.30, p < 0.01). Having a family care coordinator was associated with higher scores in being confused about managing health (β = 0.20, p <0.05). Further analysis found that higher care coordinator’s involvement was significantly associated with lower scores of receiving conflicting advice (β=-0.16, p<0.01) and being confused about managing health (β =-0.10, p<0.05). It was also associated with having higher scores in care satisfaction (β=0.15, p<0.05) and person-centered care (β=0.16, p<0.01).

Conclusion and Implications: These results demonstrate the effects of having a care coordinator on older adults’ care satisfaction and perceptions of quality of care. Involving family care coordinators might even reduce care satisfaction. This study suggests the quality of care coordination should be addressed by hiring workers with health-related educational backgrounds or offering more educational and training programs for family care coordinators. A high quality care coordination that involves frequent contact with participants is more likely to improve the quality of care. Overall, the results emphasized the importance of increasing care coordinator’s service quality and qualifications. More efforts should be made to ensure that the care coordination meets older adults’ needs and preferences in the delivery of high quality and person-centered care.