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Complex patients face healthcare barriers, but primary care teams can improve engagement. Five strategies were identified, showing that supportive team structures can mitigate burnout and counter marginalization.

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United Statesbehavioral healthchronic conditionshealth care teamshealth service improvementinterprofessional teamslow-income patientsmixed methodspatient engagementpatient-centered practiceprimary carequalitative

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Area of Science:

  • Health Services Research
  • Primary Care Medicine
  • Sociology of Health

Background:

  • Low-income patients with co-occurring physical and behavioral health conditions (complex patients) face significant barriers to high-quality healthcare.
  • Existing medical settings often misalign with the unique health and sociocultural resources of complex patients, hindering engagement.
  • These barriers lead to poor health outcomes, but this is not an inevitable consequence.

Purpose of the Study:

  • To examine strategies employed by interprofessional primary care teams to improve engagement among complex patients.
  • To understand the mechanisms, burdens, and benefits associated with these engagement strategies from the team's perspective.

Main Methods:

  • In-depth interviews were conducted with two interprofessional primary care teams.
  • Surveys were administered to all six teams within a complex patient program.
  • Qualitative and quantitative data were analyzed to identify team strategies and their impact.

Main Results:

  • Five distinct primary care team strategies for enhancing complex patient engagement were identified.
  • Team member burnout was a common challenge, but the team structure provided professional support that mitigated this effect.
  • Team perspectives revealed insights into the processes of improvement and the professional trade-offs involved.

Conclusions:

  • Interprofessional primary care teams can develop effective strategies to improve engagement for complex patients.
  • Supportive team structures are crucial for mitigating professional burdens like burnout.
  • These efforts are vital for countering healthcare marginalization among vulnerable patient populations.