Back to Search
Start Over
Identifying high-need patients with multimorbidity from their illness perceptions and personal resources to manage their health and care: a longitudinal study.
- Source :
- BMC Family Practice; 4/29/2020, Vol. 21 Issue 1, p1-14, 14p, 1 Diagram, 6 Charts, 1 Graph
- Publication Year :
- 2020
-
Abstract
- Background: A proactive person-centred care process is advocated for people with multimorbidity. To that aim, general practitioners may benefit from support in the identification of high-need patients, i.e. patients who are high or suboptimal users of health services and/or have a poor quality of life. To develop such support, we examined whether knowledge about patients' illness perceptions and personal resources to manage their health and care is useful to identify high-need patients among multimorbid general practice populations. Methods: Survey data, collected in 2016 and 2017, of 601 patients with two or more chronic diseases (e.g. COPD, diabetes, Parkinson's disease) registered with 40 general practices in the Netherlands were analysed by logistic regression analysis to predict frequent contact with the general practice, contact with general practice out-of-office services, unplanned hospitalisations and poor health related quality of life. Patients' illness perceptions and personal resources (education, health literacy, mastery, mental health status, financial resources, social support) were included as predictors. Results: The four outcomes were only weakly associated among themselves (Phi.07–.19). Patients' illness perceptions and personal resources were of limited value to predict potentially suboptimal health service use, but they were important predictors of health related quality of life. Patients with a poor health related quality of life could be identified by their previously reported illness perceptions (attributing many symptoms to their chronic conditions (B = 1.479, P <.001), a high level of concern (B = 0.844, P =.002) and little perceived control over their illness (B = -0.728, P =.006)) combined with an experienced lack of social support (B = -0.527, P =.042) and a poor mental health status (B = -0.966, P =.001) (sensitivity 80.7%; specificity 68.1%). Conclusions: Multimorbid patients who frequently contact the general practice, use general practice out-of-office services, have unplanned hospitalisations or a poor health related quality of life are largely distinct high-need subgroups. Multimorbid patients at risk of developing a poor quality of life can be identified from specific illness beliefs, a poor mental health status and unmet social needs. [ABSTRACT FROM AUTHOR]
- Subjects :
- CHRONIC diseases
FAMILY medicine
HEALTH services accessibility
LONGITUDINAL method
MEDICAL needs assessment
MEDICAL care use
NEEDS assessment
QUALITY of life
HEALTH self-care
COMORBIDITY
LOGISTIC regression analysis
ECONOMIC status
PSYCHOSOCIAL factors
SOCIAL support
EDUCATIONAL attainment
AT-risk people
PATIENT-centered care
HEALTH literacy
PATIENTS' attitudes
ATTITUDES toward illness
Subjects
Details
- Language :
- English
- ISSN :
- 14712296
- Volume :
- 21
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- BMC Family Practice
- Publication Type :
- Academic Journal
- Accession number :
- 142972875
- Full Text :
- https://doi.org/10.1186/s12875-020-01148-3