Faculty Collaboration Database

Ambulatory Care Coordination Issues With Dual Use Veteran Organ Transplant Recipients. Prog Transplant 2017 Jun;27(2):187-191

Date

06/16/2017

Pubmed ID

28617159

DOI

10.1177/1526924817699963

Scopus ID

2-s2.0-85020629676 (requires institutional sign-in at Scopus site)   10 Citations

Abstract

The previous literature indicates that patients receiving ongoing care in both Veterans Affairs (VA) and non-VA setting (dual care) may have reduced health outcomes. The objective of this study was to assess the impact of dual care provided to a veteran solid organ transplant population. This was a retrospective cohort study of stable solid organ transplant recipients receiving care at both a Veterans Affairs Medical Center and transplant center. Forty-six veteran organ transplant recipients met inclusion criteria. At baseline, mean age at transplant was 57 ± 10 years; 93% were male, 61% received kidney transplants. Thirty-nine percent of patients did not receive immunosuppressant concentrations at the recommended intervals. The incidence of veterans that had at least 2 providers caring for the same comorbidity was 63% for hypertension, 58% for diabetes, and 27% for dyslipidemia. Approximately one-third of veterans had documentation of care provided by the other institutions (30%-37%), and 93% of patients had medication regimen discrepancies between health-care systems, with 52% of patients having at least 1 medication discrepancy involving an immunosuppressant. Most veteran solid organ transplant recipients receive care across multiple health-care systems, with significant care coordination issues leading to gaps and duplications in their management. Improved communication between health systems is imperative to optimize outcomes in dual use veterans such as organ transplant recipients.

Author List

Thrall SA, Egede LE, Taber DJ

Author

Leonard E. Egede MD Center Director, Chief, Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Ambulatory Care
Cohort Studies
Comorbidity
Continuity of Patient Care
Delivery of Health Care
Diabetes Mellitus
Dyslipidemias
Female
Graft Rejection
Health Facilities
Humans
Hypertension
Immunosuppressive Agents
Interdisciplinary Communication
Male
Middle Aged
Organ Transplantation
Retrospective Studies
United States
United States Department of Veterans Affairs
Veterans