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.
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Adults Under 65 with Disabilities
People with Advanced Illness
Frail Older Adults
People with Multiple Chronic Conditions
People with Behavioral Health and Social Needs
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?
Level of Evidence
PromisingWhat does this mean?