22 Oct High-Needs, High-Cost Patients: Using Value-Based Interventions to Overcome Barriers to Care
MedicalResearch.com Interview with:
Dr. Buck
David S Buck, MD, MPH
Associate Dean of Community Health
Professor, Clinical Sciences
University of Houston – College of Medicine
Houston, TX 77204
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: High-Needs, High-Cost (HNHC) patients account for 5% of the general population and cost 50% of the healthcare spending. In Harris County, one patient alone costed $439,600 in a year when he visited multiple medical, social and behavioral agencies for care. This was a result of siloed systems working independently of each other leading to inefficient care for the patient. By providing coordinated care, using patient-centered goals and values, we are able to better engage and provide a holistic approach to patient care.
This paper introduces a novel ‘values-based’ intervention mechanism for the HNHC patients, in addition to a coordinated care management approach, through a single record system. The findings indicate an improved daily functioning of the HNHC patients over 4 months, improved relationship between the providers and the patients and moderate well-being scores.
MedicalResearch.com: What should readers take away from your report?
Response: Billions of dollars are spent every year caring for High-Needs, High-Cost patients, where most of the problems are social, not medical. For example, if someone with a serious mental illness, diabetes and also is in the social crisis of homelessness or no access to transportation access, goes to, an emergency room, their underlying problems go unaddressed and are discharged out of the hospital. Hospitals are ill fit to deliver chronic medical care or social care. But if the housing or social needs are addressed, the medical problems are much more manageable. In the example above, there is little incentive to address the patient’s care across systems or agencies. We need to focus on providing a more integrated system of care, focused on patient values driven by data. By focusing on patient values, we are able to overcome barriers to achieve their overall health-related goals and improve quality of life.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: We need to take into consideration the social, behavioral and environmental factors that account for 80% of the patient’s health outcomes, instead of focusing on only the medical aspect that drives only 20%.
We recommend future research focused on traditionally siloed systems working together to create a cohesive system of shared data and patient records, to improve service delivery and outcomes for both social and clinical aspects.
Citation:
Values-Based Interventions in Patient Engagement for Those with Complex Needs
Stephanie L. Barker, Nick J. Maguire, Sophiya Das, Victoria Bryant, Kallol Mahata, and David S. Buck
Population Health Management 0 0:0
https://www.liebertpub.com/action/showCitFormats?doi=10.1089%2Fpop.2019.0084&area=0000000000000001
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Last Updated on October 22, 2019 by Marie Benz MD FAAD