Creating patient-centered health care systems to improve outcomes and reduce disparities

ADVOCATE (Added Value for Oral Care) is a project funded by the European Commission’s Horizon 2020 program, which aims to develop strategies for a system transition toward more patient-centered and prevention-oriented oral health care delivery within health care systems. This system should balance the restorative and preventive approaches in dental and oral health care. ADVOCATE is a partnership among 6 European Union member states, which involves collaboration among universities, state-funded health care providers, and private insurance companies in Denmark, Germany, Hungary, Ireland, the Netherlands, the United Kingdom, and Aridhia, a biomedical informatics company based in Scotland. There are 6 interrelated work packages, which aim to address the following objectives: 1) in-depth evaluation of oral health care systems in European Union member states to identify best system designs for oral disease prevention, 2) development of a set of measures to provide information on oral care delivery and oral health outcomes, 3) evaluation of a feedback approach in dental practice that aims to facilitate a change toward preventive oral health care delivery, and 4) economic evaluation of strategies to promote preventive oral health care and development of policy recommendations for oral health care systems. The project is novel in its use of data that are routinely collected by health insurance organizations, as well as the engagement of key stakeholders from dental teams, insurers, patients, and policy makers in guiding the development and progress of the project. This article outlines in detail the objectives and research methodology of the ADVOCATE project and its anticipated impact. Knowledge Transfer Statement: This commentary describes the development of policy options to promote a greater focus on disease prevention in general dental practice. The approach builds on identifying the comparative effectiveness of alternative incentive schemes, as well as methods to monitor clinical and patient-derived measures of success in creating health for patients. The article describes the development and application of the measures and the evaluation of their success in orienting clinical practice more toward disease prevention.

Download Full-text

A Consensus-Based Set of Measures for Oral Health Care

Journal of Dental Research ◽

10.1177/0022034517702331 ◽

2017 ◽

Vol 96 (8) ◽

pp. 881-887 ◽

Cited By ~ 10

Author(s):

F. Baâdoudi ◽

A. Trescher ◽

D. Duijster ◽

N. Maskrey ◽

F. Gabel ◽

...

Keyword(s):

Health Care ◽

Oral Health ◽

Health Care Providers ◽

Health Care Systems ◽

Routine Data ◽

Oral Health Care ◽

Care Providers ◽

Patient Centered ◽

Dental Practitioners ◽

Care Systems

Increasingly more responsive and accountable health care systems are demanded, which is characterized by transparency and explicit demonstration of competence by health care providers and the systems in which they work. This study aimed to establish measures of oral health for transparent and explicit reporting of routine data to facilitate more patient-centered and prevention-oriented oral health care. To accomplish this, an intermediate objective was to develop a comprehensive list of topics that a range of stakeholders would perceive as valid, important, and relevant for describing oral health and oral health care. A 4-stage approach was used to develop the list of topics: 1) scoping of literature and its appraisal, 2) a meeting of experts, 3) a 2-stage Delphi process (online), and 4) a World Café discussion. The aim was to create consensus through structured conversations via a range of stakeholders (general dental practitioners, patients, insurers, and policy makers) from the Netherlands, Germany, the United Kingdom, Ireland, Hungary, and Denmark. The study was part of the ADVOCATE project, and it resulted in a list of 48 topics grouped into 6 clusters: 1) access to dental care, 2) symptoms and diagnosis, 3) health behaviors, 4) oral treatments, 5) oral prevention, and 6) patient perception. All topics can be measured, as they all have a data source with defined numerators and denominators. This study is the first to establish a comprehensive and multiple-stakeholder consented topic list designed for guiding the implementation of transparent and explicit measurement of routine data of oral health and oral health care. Successful measurement within oral health care systems is essential to facilitate learning from variation in practice and outcomes within and among systems, and it potentiates improvement toward more patient-centered and prevention-oriented oral health care.

Download Full-text

PATIENT-CENTERED MEDICINE: BACKGROUND TO THE TRANSFORMATION AND COMPONENTS

RUDN Journal of Medicine ◽

10.22363/2313-0245-2019-23-1-104-114 ◽

2019 ◽

Vol 23 (1) ◽

pp. 104-114 ◽

Cited By ~ 1

Author(s):

R. A. Khalfin ◽

V. V. Madyanova ◽

O. E. Kachkova ◽

I. D. Demina ◽

T. I. Krishtaleva ◽

...

Keyword(s):

Health Care ◽

Medical Care ◽

Health Care Systems ◽

Developed Countries ◽

The European Union ◽

Patient Centered ◽

Foreign Countries ◽

Care Systems ◽

Patient Centered Medicine ◽

Quality Of Medical Care

Purpose of the study. To analyze the concept of creating patient-oriented medicine, the prerequisites for its emergence, the difficulties of introducing it into existing health systems based on foreign experience. Materials and methods. The main materials of the study were used sources of foreign literature, which presents the concept of patient-oriented medicine, analyzed the prerequisites for changing models of health care in the European Union, USA and Asia in accordance with the principles of patient-oriented medicine, as well as data on the components and levels of patient-oriented medicine in foreign countries Results. The analyzed literature quite fully describes the difficulties of introducing patient-oriented medicine into existing health care systems. Particular attention should be paid to a multidisciplinary approach, continuity at different levels of medical care and effective communication between the physician and the patient towards the integration of this model into clinical practice. The analysis of the availability of medical care in developed countries and its dependence on social status, ethnicity and disease of the patient. Conclusion. Patient-oriented medicine is a new model for planning, implementing and evaluating medical services, which is based on mutually beneficial partnerships between medical workers, patients and their families. Taking into account the current problems of domestic health care, the introduction of the patient-oriented model will significantly improve the quality of medical care provided to the population of our country. Globally, the implementation of the principles of this model is far from complete. In the Russian Federation, targeted work in this direction requires additional scientific research, systematization of available data, and development of new legal documents

Download Full-text

Health Care Systems Support to Enhance Patient-Centered Care: Lessons from a Primary Care-Based Chronic Pain Management Initiative

The Permanente Journal ◽

10.7812/tpp/16-101 ◽

2017 ◽

Cited By ~ 1

Author(s):

Charles Elder

Keyword(s):

Primary Care ◽

Health Care ◽

Chronic Pain ◽

Pain Management ◽

Health Care Systems ◽

Patient Centered Care ◽

Chronic Pain Management ◽

Patient Centered ◽

Centered Care ◽

Care Systems

Download Full-text

Are our health care systems patient-centered? How to run a quality improvement study of the health care system?

Surgery Current Research ◽

10.4172/2161-1076-c1-032 ◽

2017 ◽

Vol 07 (05) ◽

Author(s):

Nahla Gomaa

Keyword(s):

Health Care ◽

Quality Improvement ◽

Health Care System ◽

Health Care Systems ◽

Patient Centered ◽

Care Systems ◽

Care System

Download Full-text

Shared Decision Making during the COVID-19 Pandemic

Medical Decision Making ◽

10.1177/0272989x211004147 ◽

2021 ◽

pp. 0272989X2110041

Author(s):

Anja K. Köther ◽

Katharina U. Siebenhaar ◽

Georg W. Alpers

Keyword(s):

Health Care ◽

Decision Making ◽

Shared Decision Making ◽

Online Survey ◽

Health Care Systems ◽

Shared Decision ◽

Patient Centered ◽

Convenience Sample ◽

Potential Health ◽

Care Systems

Objective The COVID-19 pandemic pushed some of the most well-developed health care systems to their limits. In many cases, this has challenged patient-centered care. We set out to examine individuals’ attitudes toward shared decision making (SDM) and to identify predictors of participation preference during the pandemic. Methods We conducted an online survey with a large convenience sample ( N = 1061). Our main measures of interest were participants’ generic and COVID-19–related participation preference as well as their acceptance and distress regarding a triage vignette. We also assessed anxiety, e-health literacy, and aspects of participants’ health. We conducted group comparisons and multiple linear regression analyses on participation preference as well as triage acceptance. Results In generic decision making, most participants expressed a strong need for information and a moderate participation preference. In the hypothetical case of COVID-19 infection, most preferred physician-led decisions. Generic participation preference was the strongest predictor of COVID-19–related participation preference, followed by age, education, and anxiety. Furthermore, both higher generic and COVID-19–related participation preferences predicted lower triage acceptance. Conclusion Our findings demonstrate potential health care recipients’ attitudes toward SDM during a severe health care crisis and emphasize that participation preference varies according to the context.

Download Full-text