Defining Team Effort Involved in Patient Care from the Primary Care Physician's Perspective

Area of Science:

• Primary Care Medicine
• Health Services Research
• Patient Management

Background:

• Understanding patient management effort is crucial for effective risk adjustment and resource allocation.
• Identifying high-effort patients can improve patient care, outcomes, and reduce clinician burnout.

Purpose of the Study:

• To identify and characterize high-effort patients from the primary care physician's perspective.
• To explore factors contributing to high-effort patient classification.

Main Methods:

• A cohort study involving 99 primary care physicians (PCPs) in an academic network.
• PCPs identified high-effort and complex patients from their panels.
• Analysis of factors (medical, behavioral, socioeconomic) influencing PCP decisions on patient effort.

Main Results:

• 23.7% of patients were classified as high-effort, and 27.9% as complex.
• Behavioral health issues drove effort in younger patients; medical/care coordination issues predominated in older patients.
• High-effort patients had significantly higher rates of medical and behavioral health problems, more frequent visits, and greater acute care utilization.

Conclusions:

• A significant portion of high-effort patients, as defined by PCPs, are not considered medically complex.
• These high-effort patients often present with substantial psychosocial issues.
• Current risk adjustment models may not adequately account for the needs of these high-effort patients.