Primary care physician insights into a typology of the complex patient in primary care

Primary care physicians play unique roles caring for complex patients, often acting as the hub for their care and coordinating care among specialists. To inform the clinical application of new models of care for complex patients, we sought to understand how these physicians conceptualize patient com...

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Vydáno v:Annals of family medicine Ročník 13; číslo 5; s. 451
Hlavní autoři: Loeb, Danielle F, Binswanger, Ingrid A, Candrian, Carey, Bayliss, Elizabeth A
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States 01.09.2015
Témata:
Adult
Attitude of Health Personnel
Chronic Disease
Comorbidity
Female
Humans
Interviews as Topic
Male
Middle Aged
Perception
Physicians, Primary Care - psychology
Primary Health Care - organization & administration
Qualitative Research
key informant/depth interviewing
mental health
practice-based research
qualitative methods
chronic care
comorbidity/multimorbidity
social factors in health and health care
primary care issues
ISSN:1544-1717, 1544-1717
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Shrnutí:Primary care physicians play unique roles caring for complex patients, often acting as the hub for their care and coordinating care among specialists. To inform the clinical application of new models of care for complex patients, we sought to understand how these physicians conceptualize patient complexity and to develop a corresponding typology. We conducted qualitative in-depth interviews with internal medicine primary care physicians from 5 clinics associated with a university hospital and a community health hospital. We used systematic nonprobabilistic sampling to achieve an even distribution of sex, years in practice, and type of practice. The interviews were analyzed using a team-based participatory general inductive approach. The 15 physicians in this study endorsed a multidimensional concept of patient complexity. The physicians perceived patients to be complex if they had an exacerbating factor-a medical illness, mental illness, socioeconomic challenge, or behavior or trait (or some combination thereof)-that complicated care for chronic medical illnesses. This perspective of primary care physicians caring for complex patients can help refine models of complexity to design interventions or models of care that improve outcomes for these patients.
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:1544-1717
1544-1717
DOI:10.1370/afm.1840