TY - JOUR
T1 - Effects of Fragmentation and the Case for Greater Cohesion in Neurologic Care Delivery
AU - O'Neal, Mary A.
AU - Zecavati, Nassim
AU - Yu, Melissa
AU - Spain, Rebecca
AU - Friedenberg, Scott M.
AU - El Husseini, Nada
AU - Torres-Russotto, Diego R.
AU - Feliciano, Briseida
AU - Spears, Roderick
AU - Baca, Christine
N1 - Funding Information:
M.A. O'Neal does consulting work for Best Docs and Crico malpractice carrier. N. Zecavati consulting fees from Sunovion. S.M. Friedenberg has been a speaker for Alexion. R. Spears is a consultant for Biohaven, AbbVie/Allergan, and Lundbeck. C. Bacca is a Consultant DOD: Congressionally Directed Medical Research Programs. R. Spain receives research support from the Department of Veterans Affairs (RX002682), The National Multiple Sclerosis Society (R-1705-27628, CA 1073-A-4), and the MS Society of Canada (MSSC Research Grant). She served on an advisory board for TG Therapeutics. M. Yu received research support from the Alzheimer's Association and Biogen and has a noncompensated position on the Epic Neuroscience steering board. B. Feliciano reports 2 grants—Genetic Characterization of the Risk of Alzheimer's Disease in the Puerto Rican Population Grant number 1rf1ago54074 and Genomic Characterization of Alzheimer Disease Risk in Admixed Populations with Native American and Southern European Genetic Ancestry Project number 1R01AG070864. D. Torres-Russotto has served as a consultant for AbbVie, Acorda, Acadia, Sunovion, Ipsen, Lundbeck, and Revance. He has also participated in speakers' bureau for Acorda, Adamas, Ipsen, AbbVie, Kyowa-Kirin, Teva, and Sunovion. N. El Husseini reports no disclosures relevant to the manuscript. Go to Neurology.org/N for full disclosures.
Publisher Copyright:
Copyright © 2021 American Academy of Neurology
PY - 2022/1/25
Y1 - 2022/1/25
N2 - Goals To define fragmentation in neurologic care delivery, explain the positive and negative drivers in neurologic practice that contribute to fragmentation, illustrate situations that increase fragmentation risk, emphasize the costs and impact on both patients and providers, and propose solutions that allow for more cohesive care. Work Group The Transforming Leaders Program (TLP) class of 2020 was tasked by American Academy of Neurology (AAN) leadership to identify the leading trends in inpatient and outpatient neurology and to predict their effects on future neurologic practice. Methods Research material included AAN databases, PubMed searches, discussion with topic experts, and AAN leadership. Results Trends in care delivery are driven by changes in the work force, shifts in health care delivery, care costs, changes in evidence-based care, and patient factors. These trends can contribute to care fragmentation. Potential solutions to these problems are proposed based on care models developed in oncology and medicine. Limitations This article shares our opinions as there is a lack of evidence-based guidelines for optimal neurologic care delivery.
AB - Goals To define fragmentation in neurologic care delivery, explain the positive and negative drivers in neurologic practice that contribute to fragmentation, illustrate situations that increase fragmentation risk, emphasize the costs and impact on both patients and providers, and propose solutions that allow for more cohesive care. Work Group The Transforming Leaders Program (TLP) class of 2020 was tasked by American Academy of Neurology (AAN) leadership to identify the leading trends in inpatient and outpatient neurology and to predict their effects on future neurologic practice. Methods Research material included AAN databases, PubMed searches, discussion with topic experts, and AAN leadership. Results Trends in care delivery are driven by changes in the work force, shifts in health care delivery, care costs, changes in evidence-based care, and patient factors. These trends can contribute to care fragmentation. Potential solutions to these problems are proposed based on care models developed in oncology and medicine. Limitations This article shares our opinions as there is a lack of evidence-based guidelines for optimal neurologic care delivery.
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U2 - 10.1212/WNL.0000000000013079
DO - 10.1212/WNL.0000000000013079
M3 - Article
C2 - 34795048
AN - SCOPUS:85124071240
SN - 0028-3878
VL - 98
SP - 146
EP - 153
JO - Neurology
JF - Neurology
IS - 4
ER -