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Caring for high-need patients.

Susanne Hempel1, Maria Bolshakova2, Michael Hochman3

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Summary
This summary is machine-generated.

Understanding high-need patients requires identifying common patient, professional, and organizational needs. Interventions must address these domains while considering unintended consequences for better healthcare system design.

Keywords:
Care stakeholdersEnvironmental scanExpert panelHigh need patientsKey informants

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Area of Science:

  • Healthcare Management
  • Health Services Research
  • Patient-Centered Care

Background:

  • High-need patients present complex challenges to healthcare systems.
  • Existing approaches often lack a comprehensive understanding of diverse patient, professional, and organizational needs.
  • A clear definition and domain identification are crucial for effective intervention development.

Purpose of the Study:

  • To explore the construct of "high need" and identify common need domains.
  • To categorize interventions used by health care systems to address these needs.
  • To examine potential unintended consequences of these interventions.

Main Methods:

  • A modified Delphi panel approach was employed, integrating an environmental scan.
  • Expert stakeholders included patients, interdisciplinary healthcare practitioners, implementation scientists, and policymakers.
  • Data collection involved a rapid literature review, key informant interviews, and online surveys for consensus building.

Main Results:

  • Common need domains were identified across patients (11 domains), care professionals (5 domains), and organizations (8 domains).
  • A taxonomy of 15 intervention categories was developed, targeting patients, professionals, or organizations.
  • Potentially unintended consequences were identified, including patient costs and professional burden.

Conclusions:

  • Differentiating need domains offers targeted intervention strategies for high-need patients.
  • Interventions should be carefully designed to mitigate unintended downstream effects on all stakeholders.
  • A nuanced approach considering patient, professional, and organizational factors is essential for effective care.