Resource planning for patient-centered, collaborative care.
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.
Wasson
John H
JH
Dartmouth Medical School, Hanover, NH 03755 , USA. john.h.wasson@dartmouth.edu
Ahles
Tim
T
Johnson
Debbie
D
Kabcenell
Andrea
A
Lewis
Ann
A
Godfrey
Margie M
MM
D000368:Aged; D000553:Ambulatory Care / Q000458:organization & administration*; D002908:Chronic Disease; D018849:Controlled Clinical Trials as Topic; D003299:Cooperative Behavior; D005246:Feedback; D005260:Female; D006295:Health Resources; D006801:Humans; D008297:Male; D017146:Models, Organizational; D010347:Patient Care Planning; D010353:Patient Education as Topic; D018802:Patient-Centered Care; D012648:Self Care; D013672:Technology; D014481:United States