Resource Planning for Patient-centered, Collaborative Care

Abstract

In this article, we use self-reported information from 13,271 older adults and the results from several controlled trials to construct a planned-care management strategy that cuts across diseases and conditions and also addresses health disparities attributed to low socioeconomic status. Three strata result from the interaction of patients' financial status, the presence or absence of bothersome pain and psychosocial problems, and their confidence with self-care. A majority of ambulatory patients generally fall in the first stratum. More resources are required in the 2 remaining strata to attain patient-centered, collaborative care. Because the planned-care management strategy is behaviorally sophisticated, it is likely to be more efficient and effective than strategies based on concepts of disease management that focus on either a single disease or groupings of patients who are "high utilizers" of healthcare. We conclude that modern technologies and related approaches make resource planning for patient-centered, collaborative care feasible and desirable.

The role of home-based information and communications technology interventions in chronic disease management: a systematic literature review

“…THC can be advantageous when used in conjunction with usual care in adult patients for specifi c chronic conditions (heart failure, diabetes), improve outcomes, and reduce costs for chronic care management when used long term [11]. Greater benefi ts from THC can be obtained when targeted at appropriate groups of patients with regards to their chronic illnesses [15] and their desire for self-management. Prospective planned-case disease management strategy can be more effective and effi cient when based on the disease per se or focused on high users of the healthcare resources and utilize fewer highly trained staff for delivery of care [15].…”

“…Greater benefi ts from THC can be obtained when targeted at appropriate groups of patients with regards to their chronic illnesses [15] and their desire for self-management. Prospective planned-case disease management strategy can be more effective and effi cient when based on the disease per se or focused on high users of the healthcare resources and utilize fewer highly trained staff for delivery of care [15]. Patients, providers and caregivers have been shown to accept and be satisfi ed with the THC approach to chronic disease management [11,16].…”

Care Coordination for Patients With Complex Health Profiles in Inpatient and Outpatient Settings

“…For example, the criteria for assigning patients to active vs monitoring status were streamlined, and minimum parameters for interaction with care team personnel were specified. It was possible to make these adjustments because, rather than engaging in ad hoc accommodation of unplanned activities (an inherently inefficient process 22 ), care coordinators can anticipate patients' multiple transitions, foster multidisciplinary relationships and lateral integration, and think about resource use at a macro level.…”

Therapists' Perceptions of how Teamwork Influences Client-Centred Practice

“…Time can also be a challenge to the implementation of this approach, especially if it is not used well (Murphy 2007). The efficient, effective and creative use of other resources, such as money, will also ensure that these are targeted to the right population at the right time (Fitzpatrick 2006, Wasson et al 2006. For example, Moulster et al (2007) encouraged team members not to waste time and money doing things that clients did not want just because they had been done in the past.…”