Development of a Care Guidance Index Based on What Matters to Patients

Paper
Key Questions Answered
  • What is a promising strategy for accurately assessing quality of life in patients with chronic conditions?
  • What is a promising strategy for identifying groups that are at risk of needing costly care?
  • What advantages does this approach have over typical risk-designation strategies?
Key Themes and Takeaways

This resource describes a care guidance index based on what matters to patients.

 

  • Identifying a high-risk subgroup is a strategy for chronic care management. However, common methods of assessing risk are often inaccurate and unhelpful.
  • In search of a better method, the authors of this study developed and tested a “what matters index” (WMI) for patients with chronic conditions. The WMI contains measures of confidence to manage health problems, level of pain, emotional problems, polypharmacy, and adverse medication effects.
  • This study found that the WMI was a good indicator of quality of life. Each sub-measure of the WMI identifies a potentially remediable need for which an intervention is possible.
  • The WMI also immediately identifies populations more likely or less likely to use costly health care.
  • However, since relatively few patients use costly care, both the WMI and a prototypic risk-designation model had comparably low positive predictive values.
  • The WMI is unlikely to predict costly care for an individual patient, but unlike risk models, the WMI can immediately guide care for every patient.
Authors
John H. Wasson
Laura Soloway
L. Gordon Moore
Paul Labrec
Lynn Ho
Population Addressed
Adults Under 65 with Disabilities
People with Advanced Illness
Frail Older Adults
People with Multiple Chronic Conditions
People with Behavioral Health and Social Needs
Level of Evidence
Promising Evidence
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