Advancing Patient-Centered Care For Individuals With Multiple Chronic Conditions
As part of a series of blog posts from leaders of the Agency for Healthcare Research and Quality (AHRQ), a posting on May 10, 2019 discusses how every day many patients and their caregivers struggle to find care that effectively addresses their needs. Clinicians also are frustrated, experiencing epidemic levels of burnout while working in systems often ill-designed to support them in addressing these fundamental objectives of healthcare delivery. This challenge is particularly pronounced for the nearly one of three American adults, and four of five Medicare beneficiaries, who are living with multiple chronic conditions (MCC). Patients with MCC account for 64% of all clinician visits, 70% of all in-patient hospital stays, 83% of all prescriptions, and 71% of all healthcare spending. Alarmingly, the number of children and adolescents with MCCs is growing as well. Currently, there is a critical mismatch between the way care is delivered (disease-specific) and the needs of patients with MCC, who require whole-person (patient-centered) care. This disconnect too often results in care that is fragmented and of suboptimal quality, leading to poor outcomes and increased costs. Furthermore, practice guidelines that help clinicians make testing and treatment decisions tend to guide the care of each of the patients’ conditions in isolation. One consequence of this narrow scope is that recommended treatments for one condition may interact harmfully with recommended treatments for another one. As a first step towards realizing this vision, AHRQ needs to have a well-conceived and effectively executed research agenda. The Care-and-Learn Model, developed by AHRQ researchers to map the work of the Agency and its research portfolio, will help identify areas of unmet need and prioritize research questions with the most value for advancing the care of individuals with MCC. The blog can be obtained here.
Effects of Early Care And Education On Children’s Health
The journal Health Affairs released a Health Policy Brief as part of an ongoing series on the social determinants of health. In “The Effects of Early Care and Education on Children’s Health,” an overview is provided of the landscape of nonparental early care and education (ECE). The focus primarily is on center-based care, including public and private preschool, child care centers, and Head Start. While the impact of ECE on children’s educational, social-emotional, and behavioral outcomes is well studied, its impact on health has become a subject of significant research interest mainly in the last 10 to 15 years. Challenges in studying the health impacts of ECE are identified and an extended summary of key studies in this area is provided. In short, while such programs are not necessarily designed to improve child health, a growing body of research indicates that they may lead to short- and long-term improvements in health-related outcomes. Additional research needs are discussed and the Brief notes that, moving forward, ECE policy must attend to promoting parental employment and improving children’s outcomes, including health outcomes. The Brief can be obtained here.
Addressing Social Determinants Of Health Through Housing Improvements
Improving the health of individuals and their neighborhoods and communities as a whole is one of the most complex and pressing challenges in health care today. Given the inextricable link between affordable quality housing and good health, housing is one area that hospitals and health systems are starting to focus on more resolutely. A new American Hospital Association (AHA) issue brief describes how hospitals are investing in affordable housing. The brief can be obtained here.
More Articles from TRENDS May 2019
LANGUAGE TRANSMISSION AND TRANSLATION
Examples are provided of how terminological inexactitudes and differences in language can influence understanding and quality of patient care. Read More
PRESIDENT’S CORNER—ASAHP MEMBER FOCUS
Ken Johnson from Weber State University is featured in this issue of TRENDS. Read More
BIPARTISAN HEALTH LEGISLATION
Describes a bipartisan bill in Congress to reauthorize workforce programs under Title VII of the Public Health Service Act and action in the House of Representatives to fund the Departments of Labor, Health and Human Services, Education, and Related Agencies (Labor-HHS). Read More
HEALTH REFORM DEVELOPMENTS
Discusses health challenges in rural areas, Medicare for All legislation, and predictive analytics to address social determinants of health. Read More
DEVELOPMENTS IN HIGHER EDUCATION
Describes an attempt to correct a mistake in the Tax Cuts and Jobs Act of 2017; re-introduction of the Student Loan Borrower Bill of Rights Act of 2019; a Trump administration proposal to reduce the Pell Grant surplus; and laws passed by states involving student loan companies. Read More
QUICK STAT (SHORT, TIMELY, AND TOPICAL)
Pregnancy-Related Deaths, United States, 2011-2015
Severe Joint Pain And Physical Inactivity Among Adults With Arthritis-United States
Wireless Sensor System To Monitor Babies In The Neonatal Intensive Care Unit (NICU)
Electric Field-Based Dressing Disrupts Bacterial Biofilm Infection To Restore Healing Read More
RANDOMIZED CLINICAL TRIALS AND THE WEIGHT OF A SOUL
Although progress has been made in research to measure the effectiveness of clinical interventions, similar lapses found in a study from the early 20th century can be observed in studies conducted today. Read More
VALIDATION OF DIGITAL HEALTH SOLUTIONS
Refers to how confidence remains low in the production of validated digital health solutions and how more standardized and transparent kinds of validation are needed. Read More