ArticleSocial science & medicine (1982)2017
Patient engagement at the margins: Health care providers' assessments of engagement and the structural determinants of health in the safety-net.
Article in Social science & medicine (1982), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Quality Indicators for High-Need Patients: a Systematic Review.Journal of general internal medicine · 2022Pooled it
- Pooled it
- An Evaluation of the Effectiveness of the Modalities Used to Deliver Electronic Health Interventions for Chronic Pain: Systematic Review With Network Meta-Analysis.Journal of medical Internet research · 2019Pooled it
- Impact on all-cause mortality of a case prediction and prevention intervention designed to reduce secondary care utilisation: findings from a randomised controlled trial.Emergency medicine journal : EMJ · 2023Trial
- Multi-Sector Assessment and Client-Perception of Social Need at Long-Term Follow-Up of a Group-Randomized Trial of Community-Engaged Collaborative Care for Adults with Depression.International journal of environmental research and public health · 2022Trial
- Merit-Based Incentive Payment System: longitudinal performance and uneven rewards for safety-net providers over 5 years.Health affairs scholar · 2025Article
- Primary care team perspectives on approaches to engaging patients in treatment for opioid use disorder.Journal of substance use and addiction treatment · 2024Article
- Article
- Patient and Provider Perspectives on Processes of Engagement in Outpatient Treatment for Opioid Use Disorder: A Scoping Review.Community mental health journal · 2024Article
- Conceptualizing and redefining successful patient engagement in patient advisory councils in learning health networks.Learning health systems · 2024Article
- Accounting for the interplay of interpersonal and structural trauma in the treatment of chronic non-cancer pain, opioid use disorder, and mental health in urban safety-net primary care clinics.SSM. Mental health · 2023Article
- Types of Engagement Strategies to Engage High-Risk Patients in VA.Journal of general internal medicine · 2023Article
- The ISoP PatEG-SIG for Promoting Patient Engagement in Pharmacovigilance: A Change of Paradigm is Needed.Drug safety · 2023Article
- From Apathy to Structural Competency and the Right to Health: An Institutional Ethnography of a Maternal and Child Wellness Center.Health and human rights · 2023Article
- Social service providers' perspectives on caring for structurally vulnerable hospital patients who use drugs: a qualitative study.BMC health services research · 2022Article
- Unpacking complex interventions that manage care for high-need, high-cost patients: a realist review.BMJ open · 2022Review
- "Housing Is Health Care": Treating Homelessness in Safety-net Hospitals.Medical anthropology quarterly · 2022Article
- Patient- and Community-Oriented Primary Care Approaches for Health in Rural, Remote and Resource-Dependent Places: Insights for Eco-Social Praxis.Frontiers in public health · 2022Review
- Assessing and promoting partnership between patients and health-care professionals: Co-construction of the CADICEE tool for patients and their relatives.Health expectations : an international journal of public participation in health care and health policy · 2021Article
- Correlation of Patient Activation Measure Level with Patient Characteristics and Type of Vascular Disease.Annals of vascular surgery · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
Increasing "patient engagement" has become a priority for health care organizations and policy-makers seeking to reduce cost and improve the quality of care. While concepts of patient engagement have proliferated rapidly across health care settings, little is known about how health care providers make use of these concepts in clinical practice. This paper uses 20 months of ethnographic and interview research carried out from 2015 to 2016 to explore how health care providers working at two public, urban, safety-net hospitals in the United States define, discuss, and assess patient engagement. We investigate how health care providers describe engagement for high cost patients-the "super-utilizers" of the health care system-who often face complex challenges related to socioeconomic marginalization including poverty, housing insecurity, exposure to violence and trauma, cognitive and mental health issues, and substance use. The health care providers in our study faced institutional pressure to assess patient engagement and to direct care towards engaged patients. However, providers considered such assessments to be highly challenging and oftentimes inaccurate, particularly because they understood low patient engagement to be the result of difficult socioeconomic conditions. Providers tried to navigate the demand to assess patient engagement in care by looking for explicit positive and negative indicators of engagement, while also being sensitive to more subtle and intuitive signs of engagement for marginalized patients.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.