The Patient Speaks: More Home Care, Care-Management Help, Telemedicine, Could Improve Outcomes and Reduce Costs

High-need, high-care patients taking part in focus group discussions arranged by Weill Cornell Medicine researchers have identified steps for reducing overuse of emergency departments and other hospital services to deliver effective care in less expensive ways.

These are:

  • Care management assistance, such as medication reminders and help in scheduling appointments
  • At-home physical therapy and nursing services
  • Home delivery of medications and easier refills
  • Telemedicine
  • More conveniently located after-hour clinics.

The focus-group results from nearly two dozen patients and three caregivers are presented in an article published on Feb. 5 in NEJM Catalyst. High-need, high-care patients often have several chronic conditions, such as diabetes, heart disease and obesity, as well as difficulty carrying out daily functions.

“Research shows that while only about 5 percent of U.S. patients are high-need, high-cost, they represent approximately half of all healthcare spending,” said senior author, Dr. Rainu Kaushal, chair of the Department of Healthcare Policy and Research and the Nanette Laitman Distinguished Professor of Healthcare Policy and Research at Weill Cornell Medicine. “To improve care and drive down costs, we need to listen to what these patients tell us is important to them.”

“In today’s era of patient-centered care,” Dr. Kaushal said, “we should take the next step and bring in patients themselves when we design our healthcare programs.”

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