How Does Fragmentation of Care Contribute to the Costs of Care?

The researchers developed new measures of care fragmentation that can be used to assess fragmentation within episodes of care and evaluated the relationship between care fragmentation and the costs of care for Medicare beneficiaries. They hypothesized that a higher degree of fragmentation of care would be associated with higher episode-specific costs of care after controlling for type of clinical episode, severity of clinical episode, clinical comorbidities, and the sociodemographic characteristics of patients. To test this hypothesis, the researchers modified existing measures of fragmentation and developed new measures based on their relevance for episodes of care, selected an approach to measuring costs, and selected the clinical episodes for which they tested for the association between fragmentation and costs. The objective of this study was to improve quality and reduce the growth of health care costs in the U.S. by assisting the Medicare program and other insurers to measure and monitor fragmentation and target improvements to episodes with higher fragmentation.