The Impact of Nurse-Led Care Coordination on Healthcare Utilisation: A Quasi-Experimental Australian Study Using Linked Electronic Health Records

Ron Fisher (), Ou Yang (), Susan Méndez (), Crystal McPhee and Hannah Lack
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Ron Fisher: Melbourne Institute of Applied Economic and Social Research, https://melbourneinstitute.unimelb.edu.au/staff/research/staff-listings/ron-fisher
Ou Yang: Melbourne Institute of Applied Economic and Social Research, https://findanexpert.unimelb.edu.au/profile/698324-ou-yang
Susan Méndez: Melbourne Institute of Applied Economic and Social Research, https://findanexpert.unimelb.edu.au/profile/670060-susan-mendez
Crystal McPhee: Deakin University
Hannah Lack: Eastern Melbourne Primary Health Network

Melbourne Institute Working Paper Series from Melbourne Institute of Applied Economic and Social Research, The University of Melbourne

Abstract: People with complex and chronic conditions require multidisciplinary care but often experience fragmented care and higher levels of avoidable hospitalisations. In this paper, we evaluate Right Care, Better Health (RCBH) – a program that embeds community-health nurse care coordinators within general practices to deliver tailored self-management support, shared care planning, case conferencing, and referral navigation for adults with cardiovascular disease, chronic respiratory disease, or considered frail and/or at high risk of falls. Using linked general practice electronic health records, we implement an event-study difference-in-differences design to investigate how RCBH enrolment impacts patient health service utilization, using not yet enrolled patients as controls. We find that RCBH enrolment leads to a 42% increase in general practitioner (GP) visits, a 78% increase in multidisciplinary chronic disease services, a 15% increase in the number of medicines prescribed, and 69% more referrals in the quarter of RCBH enrolment. With the exception of referrals, service utilisation declines thereafter, reverting toward original levels within one to two years after enrolment. Effects were generally more pronounced for people living in more socioeconomically disadvantaged areas. These results suggest that practice-embedded, nurse-led care coordination can increase access to team-based primary and secondary care in the short term; however, analyses with longer follow-up and appraisal of downstream welfare implications are needed.

Keywords: Health; Nursing; Difference-in-Difference (search for similar items in EconPapers)
JEL-codes: C23 I12 I14 I18 (search for similar items in EconPapers)
Pages: 29 pages
New Economics Papers: this item is included in nep-inv
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