Evidence map›Paper›PMID 37996845›Full record

ArticleBMC health services research2023

Caring for high-need patients.

Susanne Hempel, Maria Bolshakova, Michael Hochman, Elvira Jimenez, Gina Thompson, Aneesa Motala, David A Ganz, Sonya Gabrielian, Samuel Edwards, James Zenner and 2 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC health services research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Susanne HempelSouthern California Evidence Review Center, University of Southern California, Los Angeles, USA. susanne.hempel@med.usc.edu.
Maria BolshakovaSouthern California Evidence Review Center, University of Southern California, Los Angeles, USA.
Michael HochmanGehr Family Center for Health Systems Science and Innovation, University of Southern California, Los Angeles, CA, USA.
Elvira JimenezVA Greater Los Angeles Healthcare System, Los Angeles, CA, USA.
Gina ThompsonSouthern California Evidence Review Center, University of Southern California, Los Angeles, USA.
Aneesa MotalaSouthern California Evidence Review Center, University of Southern California, Los Angeles, USA.
David A GanzVA Greater Los Angeles Healthcare System, Los Angeles, CA, USA.
Sonya GabrielianVA Greater Los Angeles Healthcare System, Los Angeles, CA, USA.
Samuel EdwardsVA Portland Health Care System, Portland, OR, USA.
James ZennerLos Angeles County Department of Mental Health, Los Angeles, CA, USA.
Ben DennisSouthern California Evidence Review Center, University of Southern California, Los Angeles, USA.
Evelyn ChangVA Greater Los Angeles Healthcare System, Los Angeles, CA, USA.

Funding

HSRD VA IK2 HX002282
6 · The paper itself

Abstract

objectiveWe aimed to explore the construct of "high need" and identify common need domains among high-need patients, their care professionals, and healthcare organizations; and to describe the interventions that health care systems use to address these needs, including exploring the potential unintended consequences of interventions.

methodsWe conducted a modified Delphi panel informed by an environmental scan. Expert stakeholders included patients, interdisciplinary healthcare practitioners (physicians, social workers, peer navigators), implementation scientists, and policy makers. The environmental scan used a rapid literature review and semi-structured interviews with key informants who provide healthcare for high-need patients. We convened a day-long virtual panel meeting, preceded and followed by online surveys to establish consensus.

resultsThe environmental scan identified 46 systematic reviews on high-need patients, 19 empirical studies documenting needs, 14 intervention taxonomies, and 9 studies providing construct validity for the concept "high need." Panelists explored the construct and terminology and established that individual patients' needs are unique, but areas of commonality exist across all high-need patients. Panelists agreed on 11 domains describing patient (e.g., social circumstances), 5 care professional (e.g., communication), and 8 organizational (e.g., staffing arrangements) needs. Panelists developed a taxonomy of interventions with 15 categories (e.g., care navigation, care coordination, identification and monitoring) directed at patients, care professionals, or the organization. The project identified potentially unintended consequences of interventions for high-need patients, including high costs incurred for patients, increased time and effort for care professionals, and identification of needs without resources to respond appropriately.

conclusionsCare for high-need patients requires a thoughtful approach; differentiating need domains provides multiple entry points for interventions directed at patients, care professionals, and organizations. Implementation efforts should consider outlined intended and unintended downstream effects on patients, care professionals, and organizations.

Indexed as

Delivery of Health CarePhysiciansCommunicationHumansSocial WorkersCare stakeholdersEnvironmental scanExpert panelHigh need patientsKey informants

Identifiers

PMID37996845
PMCPMC10668484

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.