Ryan Jamie, Abrams Melinda K, Doty Michelle M, Shah Tanya, Schneider Eric C
Commonwealth Fund, USA.
Issue Brief (Commonw Fund). 2016 Dec;43:1-20.
Issue: Health care costs are highly concentrated among people with multiple chronic conditions, behavioral health problems, and those with physical limitations or disabilities. With a better understanding of these patients’ challenges, health care systems and providers can address patients’ complex social, behavioral, and medical needs more effectively and efficiently. Goal: To investigate how the challenges faced by this population affect their experiences with the health care system and examine potential opportunities for improvement. Methods: Analysis of the 2016 Commonwealth Fund Survey of High-Need Patients, June–September 2016. Key findings and conclusions: The health care system is currently failing to meet the complex needs of these patients. High-need patients have greater unmet behavioral health and social issues than do other adults and require greater support to help manage their complex medical and nonmedical requirements. Results indicate that with better access to care and good patient–provider communication, high-need patients are less likely to delay essential care and less likely to go to the emergency department for nonurgent care, and thus less likely to accrue avoidable costs. For health systems to improve outcomes and lower costs, they must assess patients’ comprehensive needs, increase access to care, and improve how they communicate with patients.
医疗保健成本高度集中在患有多种慢性病、行为健康问题以及有身体限制或残疾的人群中。通过更好地了解这些患者所面临的挑战,医疗保健系统和提供者能够更有效且高效地满足患者复杂的社会、行为和医疗需求。目标:调查这一人群所面临的挑战如何影响他们在医疗保健系统中的就医体验,并审视潜在的改进机会。方法:对2016年英联邦基金会高需求患者调查(2016年6月至9月)进行分析。主要发现与结论:当前医疗保健系统未能满足这些患者的复杂需求。与其他成年人相比,高需求患者有更多未得到满足的行为健康和社会问题,并且需要更多支持来管理其复杂的医疗和非医疗需求。结果表明,若能更好地获得医疗服务并实现良好的医患沟通,高需求患者推迟必要治疗的可能性降低,因非紧急情况前往急诊室就诊的可能性降低,进而产生可避免费用的可能性也降低。为了改善医疗系统的治疗效果并降低成本,它们必须评估患者的综合需求,增加医疗服务可及性,并改善与患者的沟通方式。