The Remington Report

Chronically ill older adults who are closely supported by a nurse-physician primary care team are twice as likely to rate their healthcare as high-quality than those who receive usual care, according to a study by researchers at the Johns Hopkins Bloomberg School of Public Health.

The study found that:
• After 18 months of a randomized controlled trial, Guided Care recipients rated their primary care significantly higher than usual care recipients with regard to coordination with specialists, support for self-management, and help received with setting goals, making decisions and solving health-related problems.

• Guided Care patients were 70 percent more likely to rate the time they had to wait for an appointment when sick as “excellent” or “good.”

• Guided Care patients were 50 percent more likely to rate the ability to get phone advice as “excellent” or “good.”

Previously published data suggested that, compared to usual care patients, Guided Care patients tended to spend less time in hospitals and skilled nursing facilities and had fewer ER visits and home health episodes, producing an annual net savings for healthcare insurers (after accounting for the costs of Guided Care) of $1,365 (11 percent) per patient or $75,000 per nurse. Other studies have shown that Guided Care reduces family caregiver strain and improves physicians’ satisfaction with chronic care.