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Generating hypotheses about care needs of high utilizers: lessons from patient interviews
Dawn B Mautner1, Hauchie Pang, Jeffrey C Brenner
11 Department of Family Medicine and Community Health, University of Pennsylvania , Philadelphia, Pennsylvania.
Population Health Management
|September 28, 2013
Summary
Complex patients with high healthcare use often experience early-life trauma and difficult provider relationships. Positive relationships with care teams are crucial for their well-being and improved outcomes.
Area of Science:
- Health Services Research
- Qualitative Health Research
- Patient-Centered Care
Background:
- Previous research on improving care for high-utilizing patients yielded mixed results.
- Existing literature primarily relies on quantitative data, overlooking patient experiences.
- Complex patients often have high emergency and hospital care utilization.
Purpose of the Study:
- To identify psychosocial factors and life experiences of high-utilizing patients.
- To understand patient perspectives on their healthcare needs and interactions.
- To inform future research and care delivery for vulnerable populations.
Main Methods:
- Qualitative study using semi-structured interviews.
- 19 patients from the Camden Coalition's Care Management Team were interviewed.
- Transcripts were coded using a priori and inductive approaches.
Main Results:
- Early-life instability and trauma significantly influenced health and healthcare experiences.
- Many high utilizers reported negative past interactions with healthcare providers.
- Positive, caring relationships with providers were vital for patient well-being.
Conclusions:
- Patient trauma histories and relationship dynamics are critical for understanding high healthcare utilization.
- Future research should explore adverse childhood experiences and provider relationships in larger samples.
- New care delivery models should address patients' trauma histories to improve outcomes.
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