Patient-centered Care Model Research Articles

РЕГИОНАЛЬНЫЙ МОНИТОРИНГ ФАКТОРОВ РИСКА РАЗВИТИЯ ХРОНИЧЕСКИХ НЕИНФЕКЦИОННЫХ ЗАБОЛЕВАНИЙ ПОСЛЕ ПЕРЕНЕСЕННОГО COVID-19

Annotation. Chronic non-communicable diseases (NCD) represent a major public health problem in recent decades. NCD kill 41 million people annually, accounting for 74% of all deaths worldwide. WHO predicts that the total number of deaths from NCD will rise to 55 million by 2030 unless drastic measures are taken. Cardiovascular disease, cancer, chronic respiratory disease and diabetes are the four leading causes of premature mortality among NCD. Multimorbidity affects 65% of people over 65 years of age, requiring more patient-centred and complex models of care. The aim of the study was to conduct regional monitoring of risk factors for chronic noncommunicable diseases in geriatric patients. Outpatient charts of 152 patients aged 60 years and older who had undergone COVID-9 and had undergone an in-depth adult check-up were used for the study. The average age of the patients who underwent the dispensary was 70.0±5.7 years. Questionnaire survey of 152 patients aged 65 years and older to identify NCD and senile asthenia showed that the highest proportion of patients had risk factors for cardiovascular diseases - 63.2%, osteoporosis - 40.8%, GI diseases - 28%, senile asthenia - 27% and polypragmasia - 20.4%. 32.2% of respondents noted a decrease in memory, perception of material, impaired comprehension, loss of ability to distribute time, 30.9% experienced a decrease in mood, loss of energy, depressive state, 24.3% each experienced vision and hearing problems that impair the quality of life, and 22.4% of persons over 65 experienced difficulty in walking. Based on the results of the study, data collection modules based on the STEPS system were identified for the step-by-step assessment of risk factors for the development of chronic non-communicable diseases, and a model for a comprehensive approach to improving the health of citizens aged 60 years and older, who have the highest risk of developing NCD, was proposed.

A Framework for Bariatric Surgery Patient Care: Patient and Professional Perceptions

Abstract Introduction A multidisciplinary health team for perioperative care of the bariatric patient, sustained in a viable framework to support a long-term follow-up service, may decrease rates of complications, help the recognition of the complexity of this chronic disease, and provide a comprehensive bariatric surgery process analysis. This study aimed to analyze patients’ and professionals’ experiences with the perioperative care process and identify their perceptions of the bariatric surgery process to support the long-term management of obesity surgical treatment. Methods This qualitative study was conducted in a bariatric surgery center in south Portugal. Seven health professionals participated in one focus group, and sixteen patients participated in one of the three focus groups. Patients’ focus group script had eleven open main questions with follow-up questions to probe for more information, addressing motivations, experiences with the pre-surgery and post-surgery process, and perceptions of lifestyle changes. Results Participants reported the need for a reference professional in the hospital to contact, the importance of psychological support to help patients deal with the ‘ups and downs’ of post-surgery life, and the financial support for physical activity programs. Conclusions This research helped identify a need for a framework for long-term follow-up and showed priorities to tailor health services for managing bariatric surgery patients. New bariatric surgery programs should incorporate a diverse health team, focusing on patient support in the long-term follow-up. This team should be led by a dedicated case manager and include physical activity specialists. Key messages • The positive effects of bariatric surgery go beyond weight loss, reinforcing the importance of developing a new conceptual framework based on a patient-centered care model. • A case manager specialist on the bariatric surgery process may be the key to improving the long-term benefits of bariatric surgery.

When end of treatment situations challenge patient-centered care: a discussion paper proposing new theoretical insights

IntroductionAccording to the Institute of Medicine patient-centered medicine is one of the six crucial dimensions of health care quality. Although the patient-centered care model is widely recognized for its ethical underpinnings and effectiveness, its practical implementation still raises challenges, especially in end-of-treatment situations. This discussion paper offers an overview of the challenges facing the physician-patient relationship in end-of-treatment situations.MethodsWe developed three clinical vignettes and made some theoretical considerations about ethical issues related to the decision-making process leading to the end of treatment.ResultsWe identified two main challenges that end-of-treatment situations pose to patient-centered care: (1) when the patient’s autonomy challenges the best clinical treatment; and (2) when the proposed treatment (discontinuation of treatment) challenges the patient’s preferences.DiscussionsPatient-centered care supports personalized decision-making, in which the physician’s approach varies according to the patient’s situation and individuality. The idea of beneficence may change during care, because of acceptance of the patient’s principles or a change in the primary goal of care.

Patient-centered care model based on self-efficacy to improve self-care and quality of life of people with type 2 diabetes mellitus: A PLS-SEM approach.

The current model for managing type 2 diabetes mellitus (T2DM) is healthcare provider-centered rather than patient-centered. This approach may overlook individual patients' unique needs, potentially impacting the effectiveness of T2DM management goals. This study aimed to develop a patient-centered care model based on self-efficacy to enhance self-care and improve the quality of life for individuals with T2DM. The study employed a cross-sectional design with a sample size of 250 respondents recruited through multistage random sampling, Jember regency, East Java, Indonesia. The study variables included exogenous factors (people with T2DM, situational treatment, family, and healthcare services) and endogenous factors (self-efficacy, self-care, and quality of life). Data were collected from August to December 2022 using a questionnaire and analyzed descriptively and inferentially using SEM-PLS. The developed model was a good fit with strong predictive relevance (SRMR = 0.065; Q2 = 0.049). All exogenous factors-people with T2DM, situational treatment, family, and healthcare services-significantly affected self-efficacy (42.2%, 37%, 8.1%, and 17.3%; p <0.001). Self-efficacy had a 61.6% effect on self-care, and self-care had a 27.1% effect on quality of life (p <0.001). Only situational treatment factors had a direct effect on self-care (21.7%; p <0.001). All exogenous factors also influenced the quality of life through self-efficacy and self-care (7%, 6.2%, 1.3%, and 2.9%; p <0.05). A patient-centered care model based on self-efficacy for managing T2DM can improve self-care behaviors and quality of life for individuals with T2DM. This model can be utilized by nurses in healthcare services to enhance the management of T2DM.

Healthcare professionals’ perspectives on the barriers and facilitators of integrated childhood obesity care

BackgroundBoth the causes and consequences of childhood obesity can be complex. To provide healthcare that is suitably tailored to the specific needs of children with obesity integrated care is required. The objective of this study was to explore the perceived barriers and facilitators of healthcare professionals (HCPs) in providing integrated care for children with obesity, to support them in tailoring the healthcare approach.MethodsIn this qualitative study, semi-structured in-depth interviews were conducted with 18 healthcare professionals with experience in childhood obesity care; pediatricians, youth healthcare nurses and a youth healthcare physician. A two-phased thematic content analysis was performed: an inductive analysis with open and selective coding and a deductive analysis with axial coding using the patient-centered care model by Stewart.ResultsOverall, the healthcare professionals defined the etiology of obesity as complex, and experienced the integrated care as complicated. The results fit into the four theme-structure of the patient-centered care model, with the integrated care system as an additional fifth theme. The main barriers were perceived within the sub-themes of illness and healthcare experiences, and sensitivity over talking about weight-related issues. The main facilitators were perceived within the sub-themes of conducting a biomedical, psychosocial and lifestyle assessment, tailoring the approach to families’ situation and investing in a family-professional relationship. Weight stigma appeared to be an underlying barrier for healthcare professionals that impacted, both explicitly and implicitly, upon all themes.ConclusionsHealthcare professionals providing integrated care for children with obesity, experience this type of care as complicated and comprising many barriers and facilitators regarding the four themes of the patient-centered care model and the fifth theme of the integrated care system. This paper demonstrates the patient-centered care model could prove helpful structuring a tailored approach within integrated care. This approach supports healthcare professionals in adopting a broad perspective towards individual and environmental factors and investing in the relationship, with respect to the sensitivity and complexity of childhood obesity.

A Patient-Centered Conceptual Model of AYA Cancer Survivorship Care Informed by a Qualitative Interview Study.

Purpose: Conceptual models provide frameworks to illustrate relationships among patient-, provider-, system-, and community-level factors that inform care delivery and research. Existing models of cancer survivorship care focus largely on pediatric or adult populations whose needs differ from adolescents and young adults (AYAs). We developed a patient-centered conceptual model of AYA survivorship care. Methods: We conducted a narrative literature review of current conceptual and theoretical models of care. We engaged AYA cancer survivors (n = 25) in semi-structured one-hour telephone interviews. Most participants were in their 20s and 30s, and the majority (84%) were women. Recruitment was stratified by age and time since cancer diagnosis. We conducted a thematic analysis of interview transcripts to identify themes that exemplified patient-centered care. Results: Most participants identified as white and female. Leukemia and breast cancer were the most common cancer types. Main themes included the need for (1) care coordination, (2) ongoing mental health support, (3) connection to AYA peer support, (4) support during fertility preservation efforts, (5) support with financial burden, (6) support for quality of life, (7) information about and support with side effects and late effects, and (8) attention to the unique needs of young adults. Conclusions: We present a patient-centered conceptual model of AYA survivorship care needs that can inform future cancer care delivery and research.

Clinical Review of Non-invasive Ventilation.

Noninvasive ventilation (NIV) is the mainstay to treat patients who need augmentation of ventilation for acute and chronic forms of respiratory failure. The last several decades has witnessed an extension of the indications for NIV to a variety of acute and chronic lung diseases. Evolving advancements in technology and personalised approaches to patient care make it feasible to prioritise patient centered care models that deliver home-based management using telemonitoring and telemedicine systems support. These trends may improve patient outcomes, reduce healthcare costs, and improve the quality of life for patients who suffer from chronic diseases that precipitate respiratory failure.

Enhancing Patient-Centered Care in Nigeria: Challenges, Opportunities, and Future Directions

Patient-Centered Care (PCC) is a healthcare approach that prioritizes the needs, preferences, and values of patients, aiming to enhance the overall quality of care by actively involving patients in their healthcare decisions. In Nigeria, the implementation of PCC faces significant challenges due to socioeconomic disparities, cultural influences, resource limitations, and infrastructural constraints. Despite these obstacles, there are substantial opportunities to improve Nigeria’s healthcare system through the integration of PCC principles. This review provides a comprehensive analysis of the current state of PCC in Nigeria, examining the healthcare system’s structure, successful PCC models, and the barriers hindering its widespread adoption. The review also explores strategies for enhancing PCC, including community engagement, technological innovations, and collaborative care models, and highlights the impact of PCC on health outcomes, such as improved patient satisfaction and cost-effectiveness. Additionally, the review discusses the critical role of policy and governance in promoting PCC, offering insights from international experiences and presenting case studies that illustrate the successes and challenges of implementing PCC in Nigeria. By addressing these key aspects, the review outlines a roadmap for advancing PCC in Nigeria, emphasizing the need for supportive policies, capacity building, and continuous evaluation to align the healthcare system with global standards and improve patient outcomes. Keywords Patient-Centered Care, Nigeria, Challenges, Opportunities, Future Directions

Patient-Centered Care Model’s Effectiveness in Reducing Patient Waiting Time in the Emergency Department: A Systematic Literature Review

&lt;b&gt;&lt;i&gt;Introduction:&lt;/i&gt;&lt;/b&gt; The emergency department (ED) is an essential component of any hospital that offers round-the-clock urgent treatment to patients in critical condition. However, lengthy waiting times are expected, which may negatively affect the patient’s health and overall experiences. This systematic review aims to assess the effectiveness of patient-centered care (PCC) models in reducing the time patients spend waiting in the emergency room by synthesizing the available evidence. This was conducted by following the following three research objectives: (i) to identify patient-centered care models implementation in hospital settings, (ii) to assess the effectiveness of patient-centered care models in improving patient outcomes in hospital settings, and(iii) to investigate the impact of prolonged waiting time on healthcare utilization in the ED. &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; In this systematic review design to be included, an article had to be: full text, in English, peer-reviewed, address the evaluation of the effectiveness of the PCC model in reducing ED wait times, and the ED. Studies were excluded if they were abstracts, not fully available, published in any language other than English, were not peer-reviewed, did not meet the date of search, and were systematic reviews. The study was conducted by computerized databases which included PubMed, MEDLINE, Embase, Scopus, Web of Science, and CINHAL were searched between April 1, 2023–April 17, 2023. The study used the updated Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) statement which has been updated to PRISMA 2020, a reporting guideline designed to address the issue of inadequate systematic review reporting. All the articles that satisfied the predefined inclusion criteria were independently assessed for risk of bias by two independent reviewer. &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; A systematic review design searched the literature on ED context with PCC as the intervention to reduce the waiting time. Two independent reviewers screened the articles (3,114) using the PRISMA and 27 articles were included. &lt;b&gt;&lt;i&gt;Conclusion:&lt;/i&gt;&lt;/b&gt; Long waiting times resulted in many adverse events for patients, such as delayed treatment and poorer clinical outcomes. PCC can exert a very impressive role contribution to EDs as patients should be integrated with health care providers in their health issues and treated from all perspectives.

Pain medication tapering for patients with Persistent Spinal Pain Syndrome Type II, treated with Spinal Cord Stimulation: A RCT-study protocol of the PIANISSIMO study.

Spinal Cord Stimulation (SCS) may provide pain relief in patients with therapy-refractory Persistent Spinal Pain Syndrome Type II (PSPS-T2). Despite the evidence that SCS can reduce disability and reduce pain medication usage, only 25% of the patients is able to completely omit pain medication usage after 12 months of SCS. To tackle the high burden of patients who consume a lot of pain medication, tapering programs could be initiated before starting a trajectory with SCS. The current objective is to examine whether a pain medication tapering program before SCS alters disability in PSPS-T2 patients compared to no tapering program. A three-arm, parallel-group multicenter randomized controlled trial will be conducted including 195 patients who will be randomized (1:1:1) to either (a) a standardized pain medication tapering program, (b) a personalized pain medication tapering program, or (c) no tapering program before SCS implantation, all with a follow-up period until 12 months after implantation. The primary outcome is disability. The secondary outcomes are pain intensity, health-related quality of life, participation, domains affected by substance use, anxiety and depression, medication usage, psychological constructs, sleep, symptoms of central sensitization, and healthcare expenditure. Within the PIANISSIMO project we propose a way to reduce the risks of adverse events, medication-induced hyperalgesia, tolerance, and dependence by providing pain medication tapering before SCS. Due to the lack of a commonly accepted in-hospital tapering approach, two different tapering programs will be evaluated in this study. If pain medication tapering programs are deemed to be more effective than no tapering on disability, this would add to the evidence towards an improved patient-centered care model in this patient group and set a clear path to advocate for pain medication tapering before SCS as the new standard treatment guideline for these patients. ClinicalTrials.gov NCT05861609. Registered on May 17, 2023.

Health-care Systems around the World: Diversity, Challenges, and Innovations

Abstract This study aims to explore the diversity of health-care systems globally, identify the challenges they face, and highlight innovative solutions being implemented to overcome these obstacles. By examining health-care models from various countries, the research seeks to understand how different systems can learn from each other to improve patient outcomes, efficiency, and sustainability. A comparative analysis was conducted across health-care systems in multiple countries, including high-income, middle-income, and low-income nations. Data were collected through a review of existing literature, health statistics, and case studies. Key metrics such as accessibility, quality of care, cost-effectiveness, and patient satisfaction were analyzed. In addition, interviews with health-care professionals and policymakers provided insights into the operational dynamics and innovation strategies within these systems. The findings reveal a wide spectrum of health-care models, from publicly funded systems to private insurance-based and mixed models. Common challenges identified include rising health-care costs, unequal access to services, and the burden of noncommunicable diseases. However, innovative practices such as digital health technologies, community-based health care, and integrated care models have shown promise in addressing these issues. The effectiveness of these innovations varied depending on the context of the health-care system in which they were implemented. In conclusion, the diversity of health-care systems worldwide presents both challenges and opportunities for innovation and improvement. While there is no one-size-fits-all solution, the successful strategies identified in this study emphasize the importance of adaptable, patient-centered care models that leverage technology and community resources. Policymakers and health-care providers should foster collaboration and learning across borders to enhance the resilience and efficiency of their health-care systems.

"I Felt Like I Mattered": Caring is a key ingredient of collaborative care for chronic illness.

To identify perceptions and experiences related to caring science and collaborative care in intervention participants of the Collaborative Care to Alleviate Symptoms and Adjust to Illness (CASA) study, a randomized, multi-site clinical trial for patients with chronic heart failure and reduced health status. Forty-five participants completed semi-structured, telephone interviews with a focus on intervention components, impact of the intervention on participants' lives, and recommendations for intervention change. Data were analyzed using an inductive content analysis approach focusing on the presence and frequency of text to identify patterns, categories, and themes across participants without an a priori code book. The validity of the identified categories was enhanced through triangulation. Three themes were identified: (1) intervention providers' caring/helping attitude and caring/helping communication; (2) care team availability to respond to concerns or questions; and (3) help with understanding and navigating the healthcare system. Patients highly value caring attitudes and communication, availability, and empowerment to understand and navigate healthcare systems. These attitudes and behaviors may be important mediators of the success of collaborative care programs. These are consistent with the theory of caring science, a framework that is relevant more broadly to patient-centered and team-based care models.

PET-CT-guided, symptom-based, patient-initiated surveillance versus clinical follow-up in head neck cancer patients (PETNECK2): study protocol for a multicentre feasibility study and non-inferiority, randomised, phase III trial

BackgroundApproximately 40% of treated head and neck cancer (HNC) patients develop recurrence. The risk of recurrence declines with time from treatment. Current guidelines recommend clinical follow-up every two months for the first two years after treatment, with reducing intensity over the next three years. However, evidence for the effectiveness of these regimes in detecting recurrence is lacking, with calls for more flexible, patient-centred follow-up strategies.MethodsPETNECK2 is a UK-based multi-centre programme examining a new paradigm of follow-up, using positron emission tomography-computed tomography (PET-CT)-guided, symptom-based, patient-initiated surveillance. This paradigm is being tested in a unblinded, non-inferiority, phase III, randomised controlled trial (RCT). Patients with HNC, one year after completing curative intent treatment, with no clinical symptoms or signs of loco-regional or distant metastasis will be randomised using a 1:1 allocation ratio to either regular scheduled follow-up, or to PET-CT guided, patient-initiated follow-up. Patients at a low risk of recurrence (negative PET-CT) will receive a face-to-face education session along with an Information and Support (I&S) resource package to monitor symptoms and be in control of initiating an urgent appointment when required. The primary outcome of the RCT is overall survival. The RCT also has an in-built pilot, a nested QuinteT Recruitment Intervention (QRI), and a nested mixed-methods study on patient experience and fear of cancer recurrence (FCR). An initial, single-arm feasibility study has been completed which determined the acceptability of the patient-initiated surveillance intervention, the completion rates of baseline questionnaires, and optimised the I&S resource prior to implementation in the RCT.DiscussionWe hypothesise that combining an additional 12-month post-treatment PET-CT scan and I&S resource will both identify patients with asymptomatic recurrence and identify those at low risk of future recurrence who will be empowered to monitor their symptoms and seek early clinical follow-up when recurrence is suspected. This change to a patient-centred model of care may have effects on both quality of life and fear of cancer recurrence.Trial registrationISRCTN: 13,709,798; 15-Oct-2021.

Developing palliative care skills in undergraduate allied health students using an interprofessional simulation-based learning experience

Introduction: There is a growing need to prepare the health workforce to work collaboratively to meet the needs of people affected by life-limiting illness. Despite the call from industry for the inclusion of palliative care in undergraduate curriculum, there are few established methods to deliver this education for interprofessional student cohorts. Where clinical experience options are limited, the simulation-based learning experience (SBLE) offers a valuable experiential learning opportunity in the preparation of students to care for dying patients and their families. This research aims to examine the impact of SBLE on the level of allied health students' confidence in delivering palliative care. Methods: A quasi-experimental, pre-test/post-test design was used with 11-point rating scales to measure the change in levels of self-reported confidence in knowledge, providing care, preparedness, management and assessment of need, and professional and ethical practice among allied health students who participated in either a face-to-face or an online palliative care SBLE. Results: A total of 130 students participated in the SBLE in 2019 and 2020. A paired-sample t-test showed improvement post simulation, with mean differences ranging from 2.87 [95% CI 2.45–3.29] for knowledge to 3.2 [95% CI 2.79–3.60] for confidence. All categories were statistically significant (p &lt; .05). Analysis of opened-ended questions indicated that after the simulation, students recognised the importance of a holistic focus and patient-centred care model. Conclusions: The SBLE improved levels of student perceived confidence for the delivery of palliative care. Educators are encouraged to use SBLE to support the development of graduate capabilities in palliative care in allied health students.

Patient-centered Care in Dentistry

Patient-centered care (PCC) in dentistry is a holistic approach that considers not just the dental condition but also the patient’s individual preferences, needs, and values (Kristensen et al., 2023). It aims to ensure that patient values guide all clinical decisions, fostering a collaborative and respectful patient-dentist relationship. It tries to make sure patients’ values determine clinical decisions so that an interaction involving both the dentist and a patient-centered approach with respect will result. This interconnection in dentistry goes further because psychosocial factors, such as experiencing dental phobia and one’s economic class, affect oral health significantly. Dental phobia, which can create treatment avoidance, accentuates the necessity of comprehending and addressing such issues to provide effective and patient-centered care (Kristensen et al., 2023). Another issue is economics, which can hinder getting care, especially when dealing with a low-income group. Data shows that PCC is associated with a reduction in the use of health resources, better patient satisfaction, and better overall health. Additionally, PCC can aid professional healthcare workers when it comes to litigation cases, and it reduces work dissatisfaction, which is another indicator of its value. Integrating objective data into treatment strategies is essential for effectively implementing PCC in dentistry. Objective data, for instance, clinical parameters that can be quantified, serve as a research basis that completes the information patients can provide regarding their subjective experiences (DrKumo, 2023). Integration of the two of them provides a broader picture of the patient’s current oral health status and the potential available treatments. For example, tracking a patient’s hard data figures of probable oral wellness indicators like gingivitis and tooth damage alongside their subjective details, such as reported symptoms or concerns, can aid in recognizing patterns and customizing treatment plans to achieve better results by offering optimized services to the patients (DrKumo, 2023). However, despite the bright side of PCC, there are also some difficulties that persist; among them, one can highlight the absence of a uniform definition and detailed recommendations for its application in dentistry. Reasonable attempts are being made to tackle them by virtue of a theory-based PCC model created with the dental setting as its core area of application. However, additional research that would entail empirical testing of the model and its practicality is needed to realize the potential for developing patient-centered care in dentistry, indicating the rising importance of this model and its timely implementation in dentistry.

The nurse’s role in a patient-centered approach for reducing COVID-19 vaccine hesitancy during pregnancy: An American Academy of Nursing consensus paper

The evidence shows that COVID-19 vaccines can reduce the risks of poor pregnancy outcomes. Yet, reluctance to vaccinate remains high in pregnant populations. In this paper, we take a precision health and patient-centered approach to vaccine hesitancy. We adopted the society-to-cells vaccine hesitancy framework to identify society, community, family, individual, and physiologic factors contributing to COVID-19 vaccine hesitancy in pregnancy. Nurses are particularly well-suited to impact the factors associated with vaccine hesitancy. Because of their proximity to the patient, nurses are positioned to provide individualized, timely health information, and clinical guidelines to assist patients with decision-making related to vaccinations. Recommendations are provided to bolster nurses’ engagement in precision health and patient-centered models of care to mitigate COVID-19 vaccine hesitancy in pregnancy.

Mental Health in Healthcare Workers Post-COVID-19: A Latin American Review and Insights into Personalized Management Strategies.

Over the COVID-19 pandemic, the impact of enduring mental health on healthcare workers has become increasingly evident. This review focuses on post-pandemic mental health challenges faced by healthcare personnel in Latin America. This highlights the persistent burden on healthcare workers, especially women, which is exacerbated by economic disparities, inadequacies in the healthcare system, and ongoing occupational stressors. Our literature review, utilizing databases such as PubMed, Scopus, and Google Scholar, scrutinized the mental health status of healthcare professionals in the region after the pandemic's peak. The analysis indicated sustained levels of psychological distress, with frontline workers and women continuing to be affected disproportionately. These findings emphasize the urgent need for personalized interventions to effectively address the complex mental health challenges in this context. This review advocates strategic interventions, including tailored psychological support, innovative diagnostics, and technological solutions, integrated into patient-centered care models. Such approaches aim to enhance the mental resilience and overall well-being of healthcare professionals across Latin America in the post-COVID era.

Optimizing healthcare resource allocation through data-driven demographic and psychographic analysis

This paper explores the multifaceted nature of healthcare resource allocation, examining demographic and psychographic analysis, data sources and analysis techniques, challenges, future directions, and innovations. Demographic analysis provides insights into population characteristics, healthcare demand, and disparities, informing targeted resource allocation strategies. Psychographic analysis complements demographic data by elucidating patient attitudes, behaviors, and preferences, guiding personalized care delivery and intervention design. A diverse array of data sources, including electronic health records, surveys, and geospatial data, underpins healthcare resource allocation. Advanced analysis techniques such as predictive analytics and machine learning unlock actionable insights from these data sources, enabling proactive resource allocation and optimization. Challenges such as data quality, bias, and ethical considerations underscore the complexity of healthcare resource allocation. However, emerging innovations, including artificial intelligence, precision medicine, and value-based care models, offer transformative potential for optimizing resource allocation and improving patient outcomes. Looking ahead, the integration of innovative technologies and patient-centered care models promises to reshape healthcare resource allocation, emphasizing equity, efficiency, and patient engagement. By navigating challenges thoughtfully and embracing future opportunities, healthcare systems can enhance resource allocation strategies to better meet the evolving needs of patients and communities. This paper explores the multifaceted nature of healthcare resource allocation, examining demographic and psychographic analysis, data sources and analysis techniques, challenges, future directions, and innovations. Demographic analysis provides insights into population characteristics, healthcare demand, and disparities, informing targeted resource allocation strategies. Psychographic analysis complements demographic data by elucidating patient attitudes, behaviors, and preferences, guiding personalized care delivery and intervention design. A diverse array of data sources, including electronic health records, surveys, administrative databases, geospatial data, and social determinants of health data, underpins healthcare resource allocation. Advanced analysis techniques such as predictive analytics, machine learning, spatial analysis, and simulation modeling unlock actionable insights from these data sources, enabling proactive resource allocation and optimization. Keywords: Healthcare Resource Allocation, Demographic Analysis, Psychographic Analysis, Data Sources, Advanced Analysis Techniques, Future Directions.

How Do We Achieve Person-Centered Care across Health Care Settings? Expanding Ideological Perspectives into Practice to Advance Person-Centered Care

Person or patient-centered care (PCC) is touted as the gold standard in geriatric medical care across care settings. However, despite more than 3 decades of research and practice initiatives, it remains a challenge to consistently implement PCC that fully places the individual at the center of care planning and the delivery process. The lack of universal implementation of PCC, we argue, may be in large part due to the use of multiple terms and ideologies leading to an inability to coordinate efforts across medical settings. This article reviews recent ideological PCC movements (“What Matters to You,” the Age Friendly Health Systems 4 Ms/5 Ms, “Whole Health,” Patient Priorities Care, and Medicare/Medicaid person-centered care initiatives), provides a discussion of how these ideologies are implemented in a nursing home setting through preference-based care and provides implications for coordinated integration of PCC across all care settings now and into the future. We argue for the need to draw on known information and validated methodologies for assessing and implementing PCC to collectively move beyond an ideological representation of the concept into an integrated model of PCC for all older adults receiving care.

The structure of academic cancer service lines: Results of an Association of American Cancer Institutes survey.

e13566 Background: An integrated cancer service line (CSL) in academic medical centers provides a patient-centered approach with the goals of improving the patient experience and clinical outcomes; managing financial operations; increasing access to clinical research; and decreasing health disparities. The Association of American Cancer Institutes (AACI) Physician Clinical Leadership Initiative Steering Committee sought to evaluate the current state of cancer services lines among the membership of AACI to identify common areas of organizational structure and function and potential areas for enhancing integration. Methods: A 29-question, mixed-methods, descriptive survey with multiple choice and short answer questions addressing the characteristics of the center’s CSL, was sent electronically to the cancer center directors and administrators at 107 academic centers on July 31, 2023, and again on August 24, 2023. Descriptive statistics were used to summarize the survey data. Results: Of 107 centers, 75 (70%) responded to the survey. Of the 68 respondents with clinical services, 58 centers (85%) had a defined CSL. Twenty-three centers (40%) noted that they did not have a formal charter defining governance and structure; 11 (48%) of the 23 are National Cancer Institute (NCI)-Designated Cancer Centers. Twenty-six (45%) reported a defined funds flow. Fifty (86%) cancer centers have a physician as a primary leader and the majority have a leadership team of two or more individuals (55, 95%). While hematology and medical oncology, radiation oncology, and surgical specialties were part of every CSL, pathology (31, 53%) and radiology (28, 48%) were included in only half of the centers. Center respondents noted that quality and safety were a primary focus (48, 83%), with regional growth (45, 78%), ambulatory operations (44, 76%), and budgeting and margin management (43, 74%) as additional responsibilities. Key performance metrics tracked by the CSL included the number of new patients (57, 98%), time to first appointment (55, 95%), and accrual to clinical trials (47, 81%), while 48% (28) tracked palliative care referrals within 90 days of death. Most CSL services, inclusive of records collection (86%), billing (86%), and coding (81%) are centralized within the center’s health system. Conclusions: There is widespread variability in the structure of academic CSLs with 40% and 55% of respondents not having a formal charter or funds flow, respectively. Leadership, key responsibilities, and metrics differed across centers. These results can serve as a tool for centers to refine their existing CSL or as a guide for CSL development. Our survey highlights a potential to evaluate CSL structures, which are inclusive of a broader series of departments and services, to determine the optimal approach for a multidisciplinary patient-centered care model. Efforts to obtain outcome data on CSL structures are warranted.