scholarly journals The Patient-Centered Care and Receipt of Preventive Services Among Older Adults With Chronic Diseases: A Nationwide Cross-sectional Study

2017 ◽  
Vol 54 ◽  
pp. 004695801772400
Author(s):  
Hailun Liang ◽  
Junya Zhu ◽  
Xiangrong Kong ◽  
May A. Beydoun ◽  
Jennifer A. Wenzel ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Diseases ◽  
Medical Expenditure Panel Survey ◽  
Preventive Services ◽  
Patient Centered Care ◽  
Medical Expenditure ◽  
Outcome Variable ◽  
Patient Centered ◽  
Cross Sectional ◽  
Centered Care

This article investigates the associations between the patient-centered care (PCC) and receipt of preventive services among older adults with chronic diseases. Data were derived from the nationally representative Medical Expenditure Panel Survey. The full-year consolidated data files from 2009 to 2013 were pooled to yield a final analytic sample (N = 16 654). Study outcomes included the receipt of 7 types of preventive screenings and 2 types of health education services. Patients’ PCC groups were categorized as PCC, partial PCC, and non-PCC, based on 9 questions classified under the 3 distinctive attributes of PCC—whole-person care, patient engagement, and enhanced access to care. Prevalence rates for each outcome variable were calculated. We estimated odds ratios from multiple logistic regressions, comparing the likelihood of outcome variables across 3 groups of patients. Adjusting for covariates, the PCC group was more likely than the non-PCC group to receive 8 types of preventive services. The partial PCC group had a greater likelihood than the non-PCC group of receiving 7 types of preventive services. Our study reveals significant associations between PCC and receipt of preventive services. PCC has demonstrated the potential to improve preventive care for older adults with chronic diseases.

Abstract 002: Patient Provider Communication and Patient-centered Outcomes Among Patients With Atherosclerotic Cardiovascular Disease in United States: Medical Expenditure Panel Survey 2010-2013

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Victor Okunrintemi ◽  
Erica Spatz ◽  
Joseph Salami ◽  
Haider Warraich ◽  
Salim Virani ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Medical Expenditure Panel Survey ◽  
Medical Expenditure ◽  
Atherosclerotic Cardiovascular Disease ◽  
Care Providers ◽  
Patient Centered ◽  
Patient Reported ◽  
Centered Care ◽  
Nationally Representative

Background: With recent enactment of Accountable Care Act, consumer reported patient-provider communication (PPC) assessed by Consumer Assessment of Health Plans Survey (CAHPS) in ambulatory settings is incorporated as a complementary value metric for patient-centered care of chronic conditions in pay-for-performance programs. In this study, we examine the relationship of PPC with select indicators of patient-centered care in a nationally representative adult US population with established atherosclerotic cardiovascular disease (ASCVD). Methods: The study population consisted of a nationally representative sample of 8223 individuals (age ≥ 18 years) representing 21.6 million with established ASCVD (self-reported or ICD-9 diagnosis) reporting a usual source of care in the 2010-2013 pooled Medical Expenditure Panel Survey (MEPS) cohort. Participants responded to questions from CAHPS that assess satisfaction with PPC (four-point response scale: never, sometimes, usually, always ) :(1) “How often providers show respect for what you had to say” (2) “How often health care providers listened carefully to you” (3) “How often health care providers explained things so you understood” (4) “How often health providers spent enough time with you” We developed a weighted PPC composite score, categorized as 1 ( never / sometimes ), 2 ( usually ), and 3 ( always ). Outcomes of interest were 1) patient reported outcomes (PRO): SF-12 physical/mental health status, 2) quality of care measures: statin and ASA use, 3) health-care resource utilization (HRU): Emergency room visits & hospital stays, 4) total annual and out of pocket healthcare expenditures (HCE). Results: As shown in the table, those with ASCVD reporting ineffective (never/sometimes) vs. effective PCC (always) were over 2-fold more likely to report poor PRO, 34% & 22% less likely to report statin and ASA use respectively, had a significantly greater HRU (OR≥ 2 ER visit: 1.40 [95% CI:1.09-1.80], OR≥ 2 hospitalization: 1.35 [95% CI:1.02-1.77], as well as an estimated $1,294 ($121-2468) higher annual HCE. Conclusion: This study reveals a strong relationship between patient-physician communication among those with established ASCVD with patient-reported outcomes, utilization of evidence based therapies, healthcare resource utilization and expenditures.

scholarly journals Adoption of a Personal Health Record in the Digital Age: Cross-Sectional Study

10.2196/22913 ◽  
2020 ◽  
Vol 22 (10) ◽  
pp. e22913
Author(s):  
Consuela Cheriece Yousef ◽  
Abin Thomas ◽  
Ahmed O Alenazi ◽  
Sumaya Elgadi ◽  
Laila Carolina Abu Esba ◽  
...  
Keyword(s):  
Health Care ◽  
National Guard ◽  
Personal Health Record ◽  
Patient Centered Care ◽  
Personal Health ◽  
Health Record ◽  
Objective Data ◽  
Patient Centered ◽  
Cross Sectional ◽  
Centered Care

Background As health care organizations strive to improve health care access, quality, and costs, they have implemented patient-facing eHealth technologies such as personal health records to better engage patients in the management of their health. In the Kingdom of Saudi Arabia, eHealth is also growing in accordance with Vision 2030 and its National Transformation Program framework, creating a roadmap for increased quality and efficiency of the health care system and supporting the goal of patient-centered care. Objective The aim of this study was to investigate the adoption of the personal health record of the Ministry of National Guard Health Affairs (MNGHA Care). Methods A cross-sectional survey was conducted in adults visiting outpatient clinics in hospitals at the Ministry of National Guard Health Affairs hospitals in Riyadh, Jeddah, Dammam, Madinah, and Al Ahsa, and primary health care clinics in Riyadh and Qassim. The main outcome measure was self-reported use of MNGHA Care. Results In the sample of 546 adult patients, 383 (70.1%) reported being users of MNGHA Care. MNGHA Care users were more likely to be younger (P<.001), high school or university educated (P<.001), employed (P<.001), have a chronic condition (P=.046), use the internet to search for health-related information (P<.001), and use health apps on their mobile phones (P<.001). Conclusions The results of this study show that there is substantial interest for the use of MNGHA Care personal health record with 70% of participants self-reporting use. To confirm these findings, objective data from the portal usage logs are needed. Maximizing the potential of MNGHA Care supports patient engagement and is aligned with the national eHealth initiative to encourage the use of technology for high-quality, accessible patient-centered care. Future research should include health care provider perspectives, incorporate objective data, employ a mixed-methods approach, and use a theoretical framework.

scholarly journals Attitudes of medical students in Pakistan toward the doctor-patient relationship

2014 ◽  
Author(s):  
Waqas Ahmad ◽  
Edward Krupat ◽  
Yumna Asmaa ◽  
Noor-E- Fatima ◽  
Rayan Attique ◽  
...  
Keyword(s):  
Medical Students ◽  
Patient Centered Care ◽  
Cross Sectional Study ◽  
Individual Characteristics ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Patient Centered ◽  
Cross Sectional ◽  
Centered Care ◽  
Academic Year

Background. We initiated this study with the aim to assess the leaning of medical students towards either a doctor-centered or a patient-centered care and explore the effects of personal attributes on it like gender, academic year etc. of the students. Methods. A cross-sectional study was conducted between July-Sep 2013. The study population consisted of 1274 medical students in years 1-5 from two medical colleges. English version of PPOS was used to assess attitudes of medical students towards doctor-patient relationship. The relationship between PPOS scores and individual characteristics like gender, academic year etc. were examined by using Independent t-test and one way ANOVA. Results. A total of 792 students formed the final sample. Characteristics associated with most patient-centered attitudes were being in 4th academic year, married, being a foreigner and belonging to a Private college (p<0.05). Characteristics associated with most doctor-centered attitudes were being in 2nd academic year, divorced, having a local origin and belonging to a Govt. college (p<0.05). Gender and having doctor parents had no bearing, statistically, on the attitudes. Conclusion. Despite ongoing debate and emphasis on a patient-centered curriculum, our study suggests that current curriculum and its teachings are not producing the results they are designed to achieve. Students should be adequately exposed to the patients from the beginning of their medical education in clinical settings which are more sympathetic to a patient-centered care.

scholarly journals A multilevel study of patient-centered care perceptions in mental health teams

2020 ◽  
Author(s):  
Francois Durand ◽  
Marie-Josée Fleury
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Professionals ◽  
Interprofessional Collaboration ◽  
Patient Centered Care ◽  
Multidisciplinary Teams ◽  
Patient Centered ◽  
Cross Sectional ◽  
Centered Care

Abstract Background: The successful combination of interprofessional collaboration in multidisciplinary teams with patient-centered care is necessary when it comes to delivering complex mental health services. Yet collaboration is challenging and patient-centered care is intricate to manage. This study examines correlates of patient-centered care such as team adaptivity and proactivity, collaboration, belief in interprofessional collaboration and informational role self-efficacy in multidisciplinary mental health teams.Method: A cross-sectional multilevel survey design was used, based on self-administered bilingual validated questionnaires. Participants (N=314) were mental health professionals and managers working in public primary care or specialized mental health services, in inpatient or outpatient settings. Results: This study showed that belief in interprofessional collaboration’s relationship with patient-centered perceptions is increased in teams with high collaboration. Collaboration is also found as a mediator, representing a process by which team adaptive and proactive behaviors are transformed into positive patient-centered perceptions.Conclusions: Our results were in line with recent studies on team processes establishing that collaboration is a key component in multilevel examinations of predictors of patient-centered care. In terms of practice, our study showed that multidisciplinary teams should know that working hard on collaboration is an answer to the complexity of patient-centered care. Collaboration is related to the teams’ ability to respond to its challenges. It is also related to individuals’ beliefs central to the delivery of interprofessional care.

scholarly journals A Multilevel Study of Patient-Centered Care Perceptions In Mental Health Teams

2020 ◽  
Author(s):  
Francois Durand ◽  
Marie-Josée Fleury
Keyword(s):  
Mental Health ◽  
Interprofessional Collaboration ◽  
Patient Centered Care ◽  
Multidisciplinary Teams ◽  
Patient Centered ◽  
Cross Sectional ◽  
Team Processes ◽  
Interprofessional Care ◽  
Centered Care ◽  
The Impact

Abstract Background: The combination of interprofessional collaboration in teams and patient-centered care is a necessary amalgamation when it comes to delivering complex mental healthy care and services. Yet collaboration is challenging and patient-centered care is intricate to manage. This study examines the impact of predictors of patient-centered care such as team adaptivity and proactivity, collaboration, belief in interprofessional collaboration, informal role self-efficacy in multidisciplinary mental health teams.Method: Cross-sectional multilevel design using self-administered bilingual validated questionnaires.Results: This study showed that belief in interprofessional collaboration’s impact on patient-centered perceptions is increased in teams with high collaboration. We also showed that collaboration is a mediator; that is, a process by which team adaptive and proactive behaviors are transformed into positive patient-centered perceptions.Conclusions: In terms of research our results are in line with recent theorising on team processes and specifically established collaboration as key in a multilevel examination of predictors of patient-centered care perceptions. In terms of practice, we showed that multidisciplinary teams should know that working hard on collaboration as an answer to the complexity of patient-centered care impacts the teams’ ability to respond to its challenges but also impacts individuals’ beliefs central to the delivery of interprofessional care.

scholarly journals Empathy and attitude toward communication skill learning as a predictor of patient-centered attitude: a cross-sectional study of dental students in Korea

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Minjung Lee ◽  
Jungjoon Ihm
Keyword(s):  
Communication Skills ◽  
Online Survey ◽  
Communication Skill ◽  
Patient Centered Care ◽  
Dental Students ◽  
Skill Learning ◽  
Reactivity Index ◽  
Patient Centered ◽  
Cross Sectional ◽  
Centered Care

Abstract Background Enhancing medical students’ practice of patient-centered care is a goal of medical schools. In addition to exploring the demographic and academic factors of the students, it is necessary to identify other attitudes and perceptions that may influence the student’s patient-centered attitude and inclination toward communication skill learning. This study aimed to assess patient-centered attitudes among dental students in Korea and identify the association between the students’ characteristics and empathy, communication skill learning attitude, and patient-centered attitude. Methods Data were collected via a cross-sectional online survey, and 312 dental students were included in the analyses. The study participants completed the Patient–Practitioner Orientation Scale (PPOS), the Interpersonal Reactivity Index (IRI), and the Communication Skills Attitude Scale (CSAS). Analyses were performed using independent samples’ t-tests, hierarchical multi-variable regression, and ANOVA with a post-hoc Tukey test. Results The students tend to be moderately patient-oriented toward the sharing subscale of PPOS score (M = 3.78, standard deviation [SD] = 0.54) and slightly more patient-centered toward the caring subscale of PPOS score (M = 4.41, SD = 0.52) of patient-centered attitudes. Being a female and a shorter academic period in dentistry were associated with attitudes toward patient-centered care. Empathy and positive attitude toward learning communication skills were also related to a patient-centered attitude, and among aspects of empathy, “empathic concern” had the greatest significant impact on patient-centered attitude. Conclusions Gender, academic period, empathy, and attitudes on learning communication skills were important influencing factors of patient-centered attitudes. Patient-centered attitude can and must be taught. Education programs should focus on enhancing empathy, emphasizing positive attitudes on learning communication skills, and conducting follow-up educational sessions to prevent students from becoming less patient-centered with an increase in duration of their academic period.

scholarly journals Does patient-centered care improve provision of preventive services?

2004 ◽  
Vol 19 (10) ◽  
pp. 1019-1026 ◽  
Author(s):  
Stephen D. Flach ◽  
Kimberly D. McCoy ◽  
Thomas E. Vaughn ◽  
Marcia M. Ward ◽  
Bonnie J. BootsMiller ◽  
...  
Keyword(s):  
Preventive Services ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Centered Care

scholarly journals PATTERNS OF PSYCHOACTIVE MEDICATION USE IN COMMUNITY-DWELLING OLDER ADULTS IN THE UNITED STATES IN 2015

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S710-S710
Author(s):  
Rashmita Bajracharya ◽  
Danya Qato
Keyword(s):  
Older Adults ◽  
Low Income ◽  
Medical Expenditure Panel Survey ◽  
The United States ◽  
Community Dwelling ◽  
Medical Expenditure ◽  
Cross Sectional ◽  
Psychoactive Medication ◽  
Community Dwelling Older Adults ◽  
Psychoactive Medications

Abstract Per the 2015 Beer’s Criteria, most psychoactive medications are identified as potentially inappropriate for use in older adults as this population is especially vulnerable to the potential adverse effects associated with psychoactive medications, including sedation, anticholinergic effects, and falls. Past studies found increasing use of psychoactive medications in community-dwelling older adults; however, patterns of use by other sociodemographic, socioeconomic, and clinical subgroups have not been explored. This is a cross-sectional analysis of 2015 Medical Expenditure Panel Survey in a sample of 6122 older adults (60-85 years). We utilized Andersen’s Behavioral Model of Health Services Utilization to guide logistic regression model development and estimated odds ratios (OR) with 95% confidence intervals (CI) to quantify the association between psychoactive use and predisposing(sex and race); enabling(marital status, education, poverty, insurance); and need-based[multi-morbidity and activities of daily living (ADL) limitations] factors. Over 30% of older adults in the U.S. reported taking a psychoactive medication in 2015. Prevalence of use was significantly higher in women (35.9%), the unmarried(34.1%), low-income(35.7%), white(34.0%), multimorbid (32.0%), and ADL limitation groups (45.9%) compared to men, married, high-income, other races, not multimorbid, and no ADL limitations groups, respectively. Female sex [OR=1.62(1.38-1.91)], low-income [OR=1.30(1.04-1.6)], multimorbidity [OR=3.2(2.6-3.9)], and ADL limitations [OR=2.2(1.7-2.8)] were identified as independent predictors of psychoactive use. There is differential use of psychoactive medications by sociodemographic, socioeconomic, and clinical factors. Given the increased complexity of pharmacotherapy regimens, especially in those with multimorbidity and ADL limitations, improved efforts aimed at prudent use of psychoactive medications should be intensified.

scholarly journals Association of Self-Reported Functional Limitations among a National Community-Based Sample of Older United States Adults with Pain: A Cross-Sectional Study

2021 ◽  
Vol 10 (9) ◽  
pp. 1836
Author(s):  
David R. Axon ◽  
Darlena Le
Keyword(s):  
United States ◽  
Medical Expenditure Panel Survey ◽  
Functional Limitations ◽  
Functional Limitation ◽  
Cross Sectional Study ◽  
Medical Expenditure ◽  
Outcome Variable ◽  
Sectional Study ◽  
Cross Sectional ◽  
Logistic Regression Models

The characteristics of self-reported functional limitations among older United States (US) adults with pain are currently unknown. This cross-sectional study aimed to determine the characteristics associated with functional limitations among non-institutionalized older (≥50 years) US adults with pain using 2017 Medical Expenditure Panel Survey (MEPS) data. Eligible subjects were alive for the calendar year, aged ≥50 years, and experienced pain within the past four weeks. Hierarchical logistic regression models were utilized to determine significant characteristics associated with functional limitations (outcome variable; yes, no). Functional limitations included difficulty with bending, stooping, climbing stairs, grasping objects, lifting, reaching overhead, standing for long periods of time, or walking. Extrapolation of national data values was possible by adjusting for the complex MEPS design. We found approximately 22 million of the 57 million older US adults (≥50 years) who reported pain had a functional limitation in 2017. Characteristics associated with functional limitations included: gender, race, ethnicity, employment status, marital status, pain intensity, physical health, number of chronic conditions, and frequent exercise status. Knowledge of characteristics associated with functional limitations may provide an opportunity to identify and resolve gaps in patient care among this population.

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