Effect of COVID-19 pandemic on the implementation of a multimorbidity person-centered care model: A qualitative study from health teams’ perspective

Zamorano, Paula; Téllez, A. Ruiz; Muñoz, Paulina; Sapag, Jaime C.; Martínez, M. Loreto

doi:10.1371/journal.pone.0265091

Cited by 3 publications

(1 citation statement)

References 5 publications

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“…The COVID-19 pandemic forced changes in lifestyle and habits, leading to changes in social behaviour [ 1 ]. The imposed lockdowns also influenced the management and healthcare activities of hospitals and clinics [ 2 , 3 ]. One of the affected healthcare services was access to the emergency room, wherein changes in the workplace structure impacted its services [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

COVID-19 pandemic and ophthalmological emergencies: a case-control analysis of the impact of lockdowns in a University Hospital in Lombardy region, Italy

Donati,

Appolloni,

Ceriani

et al. 2023

Annals of Medicine

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Purpose To evaluate the incidence of ocular pathologies seen at the ophthalmological emergency department (OED) during the national lockdown in 2020 due to the COVID-19 pandemic and compare it to the corresponding period in 2019. Methods Electronic records of patients who presented at the OED of our University Hospital in Varese, Italy during the COVID-19 lockdown were compared with that from the corresponding period in 2019. Records from the spring (2020A) and winter (2020B) lockdowns were compared with each other and with the same periods in 2019 (2019A and 2019B). Statistical analyses were performed by unpaired Student’s t -tests, Poisson’s regression and Chi-square test. Results The number of consultations at the OED significantly decreased during the COVID-19 lockdown ( p value <.0001). The largest decreases were observed in the youngest (age <15 years: –77.3%) and oldest (age >61 years, –68.5%) age groups. The proportion of men who consulted increased significantly from 61.76% in 2019A to 67.63% in 2020A, and from 54.56% in 2019B to 62.79% in 2020B. A significant reduction in deferrable consultations was also reported (from 943 in 2019 to 335 in 2020; p value <.0001). A statistically significant decrease in the number of consultations involving ocular trauma was also reported despite an increase in its proportion among all consultations for ocular pathologies in 2020. Conclusions Our evaluation showed a significant reduction in the number of OED consultations in all deferrable pathologies. Although the incidence of conditions that affect visual function was lower, these were more frequent in the lockdown period. The significant reduction in the number of deferrable consultations highlights the misuse of the OED.

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Section: Introductionmentioning

confidence: 99%

COVID-19 pandemic and ophthalmological emergencies: a case-control analysis of the impact of lockdowns in a University Hospital in Lombardy region, Italy

Donati,

Appolloni,

Ceriani

et al. 2023

Annals of Medicine

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Evaluation of the implementation progress through key performance indicators in a new multimorbidity patient-centered care model in Chile

Varela

Zamorano

Muñoz

et al. 2023

BMC Health Serv Res

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Background Complex health interventions involve deep organizational, structural, and cultural changes that challenge health teams and decision-makers. The explosion of chronic diseases has made the multimorbidity approach a global priority. The Centro de Innovación en Salud ANCORA UC implemented a Multimorbidity Patient-Centered Care Model in the Chilean public health system. Objective This study aims to evaluate the progress of the implementation of the Multimorbidity Patient-Centered Care Model in seven primary care centers through key performance indicators. Methods a set of indicators was designed to evaluate change management, operations, installation of new roles, and services and activities of the intervention strategy of the model. Key performance indicators were identified to monitor the implementation progress on minimal components for the model’s sustainability. Each item was assigned against an expected minimum score of 67% of progress from the overall score. They were monitored twice in seven primary health centers in 2019 and 2020, which intervened 22,642 patients with the intervention. Results The results showed that six of the seven primary care centers reached the minimum implementation threshold. The main advances were in operational conditions, and those with minor progress in implementation were the clinical services. Population size, organization, coordination of the health care teams, additional training, and decision-makers support were key factors that determined the degree of progress in a complex intervention. Conclusion It was possible to measure the progression of the implementation of a complex intervention through key performance indicators delivering relevant information for decision-makers that pursue a successful and faithful implementation. This study provides a valuable tool for the national scale-up of a similar model started in Chile by the Ministry of Health and other countries.

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A Review of Digital Age Transformation in the Past 25 Years (1999-2024): Enhancing Patient-Physician Health Communication Model through Patient Empowerment for Effective Shared Decision-making (Preprint)

Song,

Elson,

Bastola

2024

Preprint

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BACKGROUND The evolution of patient-physician communication has changed since the emergence of the World Wide Web. The internet has become an influential tool empowering patients with access to a breadth of health information. While such information has greatly facilitated communication between patients and physicians, it has also led to information overload and the opportunity to propagate misinformation. This could potentially result in suboptimal healthcare outcomes for patients. In the digital age, the integration of health IT, patient empowerment, strong patient-physician relationships, and shared decision-making could be increasingly important for effective health communication. OBJECTIVE This review aimed to identify key factors in health communication and demonstrate how health IT, patient empowerment, shared decision-making, and other essential elements can be utilized to optimize patient-physician healthcare communication and, ultimately, improve patient outcomes. METHODS Databases (PubMed, Web of Science, Scopus, PsycINFO, and IEEE Xplore) were searched using keywords related to patient empowerment, health IT, shared decision-making, and health communication for literature published between 1999 and Feb 2024. The data were limited with modified query using multi-database search strategy. The screening process was assisted by the web-based software tool Rayyan. The review methodology followed established protocols such as the PRISMA checklist to provide a comprehensive summary of existing research. Specifically, we explored key topics and essential elements useful for facilitating effective health communication. Topic modeling, trend analysis, and synthesis were applied to identify and assess topics, trends, evolutions, and gaps in health communication. RESULTS Our results elucidate the evolving dynamics within health communication through a detailed examination of data selection, topic modeling, and trend analysis. From a total of 397 selected studies published over the last 25 years, our analysis identified three topics: (1) Patient-physician Relationship and Shared Decision-making, (2) Patient Empowerment and Education Strategies, and (3) Healthcare Systems and Implementations. Trend analysis further indicated their intricate associations and the impact of health IT on enhancing patient-physician interactions. Our synthesis on the evolving association of health IT with changes in health communication models underscores its pivotal role in shaping patient-centered healthcare frameworks. CONCLUSIONS This review has highlighted the significant contributions of health IT to health communication in the digital age, particularly in promoting shared decision-making and patient empowerment. However, challenges such as usability, privacy concerns, and digital literacy hinder effective integration within health communication models. Additionally, there are gaps in understanding the critical role of trust, both in patient-physician relationships and between humans and machines. Future research should focus on addressing these challenges by refining health IT integration strategies and deepening our understanding of trust dynamics in digital health contexts. Additionally, exploring how emerging technologies like AI might further support these goals could also be valuable.

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Effect of COVID-19 pandemic on the implementation of a multimorbidity person-centered care model: A qualitative study from health teams’ perspective

Cited by 3 publications

References 5 publications

COVID-19 pandemic and ophthalmological emergencies: a case-control analysis of the impact of lockdowns in a University Hospital in Lombardy region, Italy

COVID-19 pandemic and ophthalmological emergencies: a case-control analysis of the impact of lockdowns in a University Hospital in Lombardy region, Italy

Evaluation of the implementation progress through key performance indicators in a new multimorbidity patient-centered care model in Chile

A Review of Digital Age Transformation in the Past 25 Years (1999-2024): Enhancing Patient-Physician Health Communication Model through Patient Empowerment for Effective Shared Decision-making (Preprint)

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