scholarly journals The challenge of determining appropriate care in the era of patient-centered care and rising health care costs

2018 ◽  
Vol 24 (3) ◽  
pp. 201-206 ◽  
Author(s):  
Ian Coulter ◽  
Patricia Herman ◽  
Gery Ryan ◽  
Lara Hilton ◽  
Ron D. Hays ◽  
...  
Keyword(s):  
Patient Preferences ◽  
The United States ◽  
Patient Centered Care ◽  
Cost Of Care ◽  
Patient Centered ◽  
Inappropriate Care ◽  
Appropriateness Of Care ◽  
Centered Care ◽  
The Cost ◽  
Care Costs

Appropriateness of care is typically determined in the United States by evidence on efficacy and safety, combined with the judgments of experts in research and clinical practice, but without consideration of the cost of care or patient preferences. The shift in focus towards patient-centered care calls for consideration of outcomes that are important to patients, accommodation of patient preferences, and incorporation of the costs of care in patient-provider shared clinical decisions. The RAND/UCLA Appropriateness method was designed to determine rates of appropriate or inappropriate care, but the method did not include patient preferences or costs. This essay examines how methods of studying appropriateness can be made more patient-centered by describing a modification of the RAND/UCLA method by including patient outcomes, preferences, and costs.

Health literacy and palliative care

2017 ◽  
Vol 25 (1) ◽  
pp. 94-95
Author(s):  
Melissa G. French
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Health Literacy ◽  
Patient Preferences ◽  
Health Care Organizations ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Centered Care ◽  
Pathway To Care

Abstract Health literacy and palliative care have been receiving more attention within health care organizations and systems in recent years. Both can offer a pathway to care that is better for patients and has the potential to be of high value. A health literate approach to palliative care provides patient-centered care that is better aligned with patient preferences and needs.

scholarly journals Shared Decision Making and Patient-Centered Care in Israel, Jordan, and the United States: Exploratory and Comparative Survey Study of Physician Perceptions (Preprint)

2020 ◽  
Author(s):  
Yaara Zisman-Ilani ◽  
Rana Obeidat ◽  
Lauren Fang ◽  
Sarah Hsieh ◽  
Zackary Berger
Keyword(s):  
United States ◽  
Decision Making ◽  
Shared Decision Making ◽  
The United States ◽  
Patient Centered Care ◽  
Survey Study ◽  
Shared Decision ◽  
Patient Centered ◽  
Centered Care ◽  
Comparative Survey

BACKGROUND Shared decision making (SDM) is a health communication model that evolved in Europe and North America and largely reflects the values and medical practices dominant in these areas. OBJECTIVE This study aims to understand the beliefs, perceptions, and practices related to SDM and patient-centered care (PCC) of physicians in Israel, Jordan, and the United States. METHODS A hypothesis-generating comparative survey study was administered to physicians from Israel, Jordan, and the United States. RESULTS A total of 36 surveys were collected via snowball sampling (Jordan: n=15; United States: n=12; Israel: n=9). SDM was perceived as a way to inform patients and allow them to participate in their care. Barriers to implementing SDM varied based on place of origin; physicians in the United States mentioned limited time, physicians in Jordan reported that a lack of patient education limits SDM practices, and physicians in Israel reported lack of communication training. Most US physicians defined PCC as a practice for prioritizing patient preferences, whereas both Jordanian and Israeli physicians defined PCC as a holistic approach to care and to prioritizing patient needs. Barriers to implementing PCC, as seen by US physicians, were mostly centered on limited appointment time and insurance coverage. In Jordan and Israel, staff shortage and a lack of resources in the system were seen as major barriers to PCC implementation. CONCLUSIONS The study adds to the limited, yet important, literature on SDM and PCC in areas of the world outside the United States, Canada, Australia, and Western Europe. The study suggests that perceptions of PCC might widely differ among these regions, whereas concepts of SDM might be shared. Future work should clarify these differences.

scholarly journals A Brief Survey on Six Basic and Reduced eHealth Indicators in Seven Countries in 2017

2018 ◽  
Vol 09 (03) ◽  
pp. 704-713 ◽  
Author(s):  
Reinhold Haux ◽  
Elske Ammenwerth ◽  
Sabine Koch ◽  
Christoph Lehmann ◽  
Hyeoun-Ae Park ◽  
...  
Keyword(s):  
Health Care ◽  
Information Processing ◽  
Health Care Professionals ◽  
The United States ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Political Will ◽  
Record Data ◽  
Centered Care ◽  
Future Work

Background Holistic, ubiquitous support of patient-centered health care (eHealth) at all health care institutions and in patients' homes through information processing is increasingly supplementing institution-centered care. While eHealth indicators may measure the transition from institution-centered (e.g., hospital-centered) information processing to patient-centered information processing, collecting relevant and timely data for such indicators has been difficult. Objectives This article aims to design some basic eHealth indicators, which are easily collected and measure how well information processing supports holistic patient-centered health care, and to evaluate penetrance of patient-centered health as measured by the indicators internationally via an expert survey. Methods We identified six basic indicators that measure access of health care professionals, patients, and caregivers to the patient's health record data and the ability of providers, patients, and caregivers to add information in the patient's record. In a survey of international informatics experts, these indicators' penetrance were evaluated for Austria, Finland, Germany, Hong Kong, South Korea, Sweden, and the United States in the summer of 2017. Results The eHealth status measured by the indicators varied significantly between these seven countries. In Finland, most practices measured by the indicators were fully implemented whereas in Germany only one practice was partially realized. Conclusion Progress in the implementation of practices that support patient-centered care could mainly be observed in those countries where the “political will” focused on achieving patient-centered care as opposed to an emphasis on institution-centered care. The six eHealth indicators seem to be useful for measuring national progress in patient-centered care. Future work will extend the number of countries analyzed.

Patient-Centered Care in a Medical Home

2011 ◽  
Vol 16 (2) ◽  
Author(s):  
Colette Carver ◽  
Anne Jessie
Keyword(s):  
Primary Care ◽  
Medical Home ◽  
The United States ◽  
Patient Centered Care ◽  
Patient Centered Medical Home ◽  
Patient Centered ◽  
Patient Centered Medical Homes ◽  
Medical Homes ◽  
Centered Care ◽  
Medical Home Model

There is general consensus that our current healthcare delivery system will not be able to supply an adequate workforce, contain costs, and meet the ever-increasing chronic-care needs of the growing and aging population in the United States (US). Some of the major challenges to the U.S. healthcare system are faced by those on the front lines, namely the healthcare workers in primary care. Part of the emerging solution for primary care is the adoption of the Patient-Centered Medical Home Model. The intent of this model is to provide coordinated and comprehensive care rooted in a strong collaborative relationship. Carilion Clinic in Southwestern Virginia is implementing this patient-centered model in which a proactive, multidisciplinary care team collectively takes responsibility for each patient. In this article we will elaborate on the concepts of patient-centered care and patient-centered medical homes, after which we will offer an exemplar describing the process that Carilion Clinic is using to establish patient-centered medical homes throughout their primary care departments. Limitations of the Patient-Centered Medical Home Model will also be discussed.

scholarly journals A Comparison of Patient-Centered Care in Pharmacy Curricula in the United States and Europe

2016 ◽  
Vol 80 (5) ◽  
pp. 83 ◽  
Author(s):  
Ines Nunes-da-Cunha ◽  
Blanca Arguello ◽  
Fernando Martinez Martinez ◽  
Fernando Fernandez-Llimos
Keyword(s):  
United States ◽  
The United States ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Centered Care

Enhancing patient-health care provider (HCP) communication in oncology care in the United States.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 99-99
Author(s):  
Suzanne Lane ◽  
Shelagh Szabo ◽  
Ron Halbert ◽  
Hans-Peter Goertz ◽  
Catherine Lai ◽  
...  
Keyword(s):  
Quality Care ◽  
Qualitative Interviews ◽  
The United States ◽  
Patient Centered Care ◽  
Communication Tool ◽  
Patient Centered ◽  
Communication Tools ◽  
Patient Goals ◽  
Centered Care ◽  
The Impact

99 Background: Patient engagement is essential for high-quality care. This study aimed to develop novel communication tools to be used between patients and HCPs to address current gaps in cancer care. Methods: Qualitative interviews were conducted with 16 US patients with various cancers and stage, 6 oncology nurses, and 4 oncologists. Goals were to understand: patients’ changing concerns at diagnosis and during treatment; HCPs views on eliciting patient preferences; and perspectives from both on improving care. A thematic analysis was conducted to identify gaps in care. 8 patients rated their experience and importance of quality care items on a scale of 1 (not experienced/not important) to 5 (experienced/very important). Two draft tools were developed to address identified gaps. Results: None of the 16 patients reported using a communication tool before or during treatment. Gaps in quality care were identified, including communication, patient-centered care, education, and comprehensive care. Communication and patient-centered care items important to patients, but not always experienced, included clearly explained treatment options, time to discuss topics of concern, patient-led decision making, an open-minded care team, and the ability to change one’s mind (mean experience ≤ 4). The first tool assesses patient’s life and treatment goals and establishes early expectations through an open-ended questionnaire. This tool aims to enrich communication between patients and HCPs, enabling more patient-centered care. The second tool addresses the importance of ongoing education using a checklist. Treatment outcomes and the impact of treatment on QOL were identified as the two most important education items for patients when making treatment decisions (mean importance = 5). This tool aims to enhance educational discussions and enable patients to specify where more information is desired. Conclusions: Patients reported a need for communication tools at the beginning of treatment, specifically related to patient goals and educational needs. With patient and HCP input, two novel communication tools were developed to improve quality care. Future studies will validate and implement the tools in clinical practice.

scholarly journals Patient centeredness: The perspectives of uninsured primary care patients in the United States

2019 ◽  
Vol 22 (1) ◽  
pp. 19-26 ◽  
Author(s):  
Akiko Kamimura ◽  
Shannon Weaver ◽  
Bianca Armenta ◽  
Bethany Gull ◽  
Jeanie Ashby
Keyword(s):  
United States ◽  
Primary Care ◽  
Health Outcomes ◽  
Patient Involvement ◽  
The United States ◽  
Patient Centered Care ◽  
Patient Centeredness ◽  
Patient Centered ◽  
Centered Care ◽  
Primary Care Patients

Introduction Patient-centered care has become increasingly important within the United States (US) healthcare system. Given that patient-centered care predicts patient satisfaction, health outcomes, and cost-effectiveness, it is of the utmost importance to study patient-centered care from the perspectives of marginalized populations including minorities, immigrants, and other underserved populations. The purpose of this study is to examine factors that affect underserved primary care patients’ perceptions of patient centeredness. Methods The data were cross-sectional and collected in Fall 2016. Free clinic patients (N = 723) completed a self-administered survey, which measures patient centeredness, patient involvement in care, and clinical empathy. Validated measures were part of the survey, and the internal consistency of scales was tested. The general linear model was performed to predict factors associated with patients’ perceptions of patient centeredness. Results Higher levels of perceived patient involvement in care and higher levels of perceived empathy in consultation are related to higher levels of patient centeredness. While better physical health is associated with higher levels of perceived empathy in consultation, high levels of emotional health and depression are not. Conclusions Patients’ perceptions of involvement and empathy are important factors for patient-centered care, although this study did not show causal directions among variables. Based on the findings of this study, it is recommended that future studies should focus on the following three points: (1) to develop and evaluate trainings for providers, (2) develop education classes for patients who utilize free clinics, (3) analyze how these programs affect patient-centered care and health outcomes.

scholarly journals The Effects Of Clinical Supervision Of Academic Model To Improve The Ability Of Nurses In Applying Patient-Centered Care (PCC) At Hospital

2018 ◽  
Vol 4 (1) ◽  
pp. 41
Author(s):  
Arifin Dwi Atmaja ◽  
MC Inge Hartini ◽  
Luky Dwi Antoro
Keyword(s):  
Clinical Supervision ◽  
Nursing Care ◽  
Discharge Planning ◽  
Life Quality ◽  
Patient Centered Care ◽  
Cost Of Care ◽  
Control Group ◽  
Patient Centered ◽  
Centered Care

Introduction: Quality patient centered care will improve the quality of nursing care and the patients independence, life quality, and self-efficacy. It also reduces the rate of disease recurrence, the length of stay (LOS), and the cost of care. Clinical supervision of academic model is a method to increase professionalism in the delivery of nursing care. The purpose of this study was to determine the effects of clinical supervision academic model of head nurses on the quality of discharge planning. The study represented a pre-post test quasi-experimental design with a control group. The population was all nurses in Mitra Siaga hospital. The samples were 51 nurses selected by non-probability sampling. The statistical analysis used was one-way ANOVA. The results showed that the clinical supervision of academic model of the head nurses had a significant effect on improving the ability of nurse in applying patient centered care. Clinical supervision of academic model is a competence that nursing managers should have; therefore, it is suggested that head nurses provide guidance and supervision continuosly to maintain and improve the quality of patient centered care.

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