Patient Priority-Directed Decision Making and Care for Older Adults with Multiple Chronic Conditions

Older adults with multiple conditions receive care that is often fragmented, burdensome, and of unclear benefit. An advisory group of patients, caregivers, clinicians, health system engineers, health care system leaders, payers, and others identified three modifiable contributors to this fragmented,...

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Vydané v:Clinics in geriatric medicine Ročník 32; číslo 2; s. 261
Hlavní autori: Tinetti, Mary E, Esterson, Jessica, Ferris, Rosie, Posner, Philip, Blaum, Caroline S
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: United States 01.05.2016
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ISSN:1879-8853, 1879-8853
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Abstract Older adults with multiple conditions receive care that is often fragmented, burdensome, and of unclear benefit. An advisory group of patients, caregivers, clinicians, health system engineers, health care system leaders, payers, and others identified three modifiable contributors to this fragmented, burdensome care: decision making and care focused on diseases, not patients; inadequate delineation of roles and responsibilities and accountability among clinicians; and lack of attention to what matters to patients and caregivers (ie, their health outcome goals and care preferences). The advisory group identified patient priority-directed care as a feasible, sustainable approach to addressing these modifiable factors.
AbstractList Older adults with multiple conditions receive care that is often fragmented, burdensome, and of unclear benefit. An advisory group of patients, caregivers, clinicians, health system engineers, health care system leaders, payers, and others identified three modifiable contributors to this fragmented, burdensome care: decision making and care focused on diseases, not patients; inadequate delineation of roles and responsibilities and accountability among clinicians; and lack of attention to what matters to patients and caregivers (ie, their health outcome goals and care preferences). The advisory group identified patient priority-directed care as a feasible, sustainable approach to addressing these modifiable factors.
Older adults with multiple conditions receive care that is often fragmented, burdensome, and of unclear benefit. An advisory group of patients, caregivers, clinicians, health system engineers, health care system leaders, payers, and others identified three modifiable contributors to this fragmented, burdensome care: decision making and care focused on diseases, not patients; inadequate delineation of roles and responsibilities and accountability among clinicians; and lack of attention to what matters to patients and caregivers (ie, their health outcome goals and care preferences). The advisory group identified patient priority-directed care as a feasible, sustainable approach to addressing these modifiable factors.Older adults with multiple conditions receive care that is often fragmented, burdensome, and of unclear benefit. An advisory group of patients, caregivers, clinicians, health system engineers, health care system leaders, payers, and others identified three modifiable contributors to this fragmented, burdensome care: decision making and care focused on diseases, not patients; inadequate delineation of roles and responsibilities and accountability among clinicians; and lack of attention to what matters to patients and caregivers (ie, their health outcome goals and care preferences). The advisory group identified patient priority-directed care as a feasible, sustainable approach to addressing these modifiable factors.
Author Posner, Philip
Tinetti, Mary E
Blaum, Caroline S
Esterson, Jessica
Ferris, Rosie
Author_xml – sequence: 1
  givenname: Mary E
  surname: Tinetti
  fullname: Tinetti, Mary E
  email: mary.tinetti@yale.edu
  organization: Section of Geriatrics, Department of Medicine, Yale School of Medicine, 333 Cedar Street, PO Box 208025, New Haven, CT 06520, USA; Yale School of Public Health, 60 College Street, New Haven, CT 06520, USA. Electronic address: mary.tinetti@yale.edu
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  givenname: Jessica
  surname: Esterson
  fullname: Esterson, Jessica
  organization: Section of Geriatrics, Department of Medicine, Yale School of Medicine, 333 Cedar Street, PO Box 208025, New Haven, CT 06520, USA
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  givenname: Rosie
  surname: Ferris
  fullname: Ferris, Rosie
  organization: Division of Geriatric Medicine and Palliative Care, Department of Medicine, Langone Medical Center, New York University, 462 First Avenue, C&D Building, Room CD612-613, New York, NY 10016, USA; Department of Population Health, Langone Medical Center, New York University, 550 First Avenue, BCD612, New York, NY 10016, USA
– sequence: 4
  givenname: Philip
  surname: Posner
  fullname: Posner, Philip
  organization: Oak Ridge Institute of Science Education, Oak Ridge Associated Universities, Oak Ridge, TN, USA; National MS Society, National Capitol Chapter
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  givenname: Caroline S
  surname: Blaum
  fullname: Blaum, Caroline S
  organization: Division of Geriatric Medicine and Palliative Care, Department of Medicine, Langone Medical Center, New York University, 462 First Avenue, C&D Building, Room CD612-613, New York, NY 10016, USA; Department of Population Health, Langone Medical Center, New York University, 550 First Avenue, BCD612, New York, NY 10016, USA
BackLink https://www.ncbi.nlm.nih.gov/pubmed/27113145$$D View this record in MEDLINE/PubMed
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Keywords Patient priorities
Fragmented and burdensome care
Patient’s health outcome goals and care preferences
Current care planning
Patient priority–directed care
Multiple chronic conditions
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Snippet Older adults with multiple conditions receive care that is often fragmented, burdensome, and of unclear benefit. An advisory group of patients, caregivers,...
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SubjectTerms Aged
Clinical Decision-Making - ethics
Clinical Decision-Making - methods
Decision Making - ethics
Humans
Multiple Chronic Conditions - psychology
Multiple Chronic Conditions - therapy
Patient Care Planning
Patient Comfort - methods
Patient Comfort - organization & administration
Patient Preference
Terminal Care - ethics
Terminal Care - methods
Terminal Care - psychology
Title Patient Priority-Directed Decision Making and Care for Older Adults with Multiple Chronic Conditions
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