Patients Overburdened with Care Coordination Hurts Patient Experience

A new poll from the American Academy of Physician Associates (AAPA) shows that care coordination has become a second job for many patients, something AAPA experts said is becoming a major pitfall for the overall patient experience.

The survey, conducted by Harris Poll on behalf of AAPA, showed that people spend up to eight hours every month on care coordination and healthcare navigation.

That finding, plus others uncovered in the poll, is indicative of the strain on the overall patient experience faced following the COVID-19 pandemic. The researchers engaged over 2,500 adult patients and found that it’s not just providers who are feeling overburdened after the pandemic.

“So much has changed in healthcare since the pandemic, and the focus has largely been on the strain that healthcare teams are experiencing,” Lisa M. Gables, CPA, the CEO of AAPA, said in a statement. “Certainly, we have to address that as we know it impacts the resiliency and strength of our healthcare workforce. However, AAPA wanted to understand from the patient perspective what is and isn’t working in healthcare today.”

That eight hours of care coordination—a task arguably better left to a provider, case manager, social worker, patient navigator, or another similar healthcare employee—doesn’t make for a good patient experience. More than half (65 percent) of respondents said coordinating their own care is “overwhelming” and “time-consuming.” Among young adults ages 18 to 34, that number jumps to 76 percent.

And for individuals coordinating care on behalf of someone else, like a child or an aging parent, those pressures are mounting, the survey indicated. Around a quarter of caregivers who are employed had to take time off work to facilitate care for their loved one, and 19 percent of all caregivers said their own health suffered.

The undue burden of healthcare navigation and care coordination may be pushing some patients to simply go without. Six in 10 (61 percent) of respondents said they only access care when they are sick, leaving preventive care by the wayside. When patients do try to book an appointment, they face long wait times. Unless patients get their appointments within the week, they are usually waiting a month to get into the clinic.

Patients are also delaying care, with 44 percent saying as much, in part because of other healthcare industry pitfalls like high costs (40 percent) and the time they’d need to take away from work or other responsibilities (30 percent).

Skipping and delaying care isn’t coming without its consequences; 60 percent of patients said delaying care had some kind of impact, although the survey did not dive more deeply into what those impacts were.

Even when patients do make their way into a clinic for an appointment, the patient experience falters, the survey continued. For one thing, patient-provider communication feels one-sided, with 64 percent of respondents saying they wished their providers took more time to understand them. Around half (49 percent) said they don’t always feel listened to by their clinicians.

Moreover, patients feel their providers could do more to help them with healthcare navigation and care coordination; 54 percent agreed their health would improve if their providers helped them understand the healthcare system.

Patient trust is also paramount, with two-thirds saying their health would improve if they could regularly work with a healthcare provider they trusted. Around half (54 percent) said that trust would grow if they could visit with a clinician who shared their background.

Survey results indicated that patients understand that many of these shortcomings are likely born from the stress providers themselves feel, especially post-pandemic. For one thing, 71 percent of respondents said they worry the demands on healthcare workers are too great, and 47 percent said they think their clinicians are burnt out and overburdened. Two-thirds (66 percent) said they think their providers appear more rushed than they have been in the past.

Those provider stressors are impacting the patient experience, survey respondents said, with 73 percent saying the healthcare system fails to meet their needs in some way and 30 percent saying they have felt rushed during a healthcare appointment.

Others are worried about the future impacts of current problems. For example, 68 percent of patients said they are worried that current workforce shortages will impact them or their family and friends as patients.

Physician associates/assistants (PAs) could be part of the solution to workforce problems, survey respondents indicated. An overwhelming 92 percent said they think the industry should better utilize PAs to address healthcare workforce shortages, and 91 percent said PA practice authority laws should be updated. Nine in ten respondents said PAs make it easier to get an appointment.

Respondents who have visited with a PA said the PA delivered safe and effective care, and 89 percent said their PA helped improve their health outcomes. Around eight in ten rated the care they got from a PA in the past 12 months as good or excellent.

“PAs are committed patient advocates, and to be a voice for patients, we must first understand the barriers patients face, how that is impacting their day-to-day life, and the long-term effects on both individuals and the healthcare system at large,” Gables explained.