Patient-centered outcomes are results of
health care
Health care, or healthcare, is the improvement or maintenance of health via the preventive healthcare, prevention, diagnosis, therapy, treatment, wikt:amelioration, amelioration or cure of disease, illness, injury, and other disability, physic ...
that can be obtained from a
healthcare professional's ability to care for their patients and their patient's families in ways that are meaningful, valuable and helpful to the patient. Patient-centered outcomes focus attention on a patient's beliefs, opinions, and needs in conjunction with a physician's medical expertise and assessment. In the
United States
The United States of America (USA), also known as the United States (U.S.) or America, is a country primarily located in North America. It is a federal republic of 50 U.S. state, states and a federal capital district, Washington, D.C. The 48 ...
, the growth of the healthcare industry has put pressure on providers to see more patients in less time, fill out paperwork in a timely manner, and stay current on the ever-changing medical advancements that occur daily. This increased pressure on healthcare workers has put stress on the provider-patient relationship. The
Patient-Centered Outcomes Research Institute
The Patient-Centered Outcomes Research Institute (PCORI) is a United States–based non-profit institute created through the 2010 Patient Protection and Affordable Care Act. It is a government-sponsored organization charged with funding Compar ...
(PCORI) is a
United States Government
The Federal Government of the United States of America (U.S. federal government or U.S. government) is the Federation#Federal governments, national government of the United States.
The U.S. federal government is composed of three distinct ...
funded research institute that funds studies that compare healthcare options to find out what options and situations work best for patients of different circumstances. PCORI uses their research to increase the quality of healthcare and push the healthcare system towards a more patient-centered approach. The Beryl Institute, a non-profit institute dedicated to the improvement of patient experience through
Evidence-based research
Metascience (also known as meta-research) is the use of scientific methodology to study science itself. Metascience seeks to increase the quality of scientific research while reducing inefficiency. It is also known as "research on research" an ...
, released data that found that over 90% of patients believe patient-centered outcomes to be "extremely important" to their healthcare experience.
Individuals that participated in this study by the Beryl Institute claimed that the aspects of healthcare that they see as most influential to their healthcare experience include effective communication, pain management, a clear and well-explained plan of care and a clean and comfortable environment.
In addition to this data, women were found to have the largest issues with lack of patient-centered care, reporting higher rates of pain and less empathy than men. In 2024, this new article highlights that patient-centered outcomes are not only vital in physical healthcare but also play a crucial role in enhancing the effectiveness of psychological treatments.
History
In the 19th century, the
United States Healthcare System began with hospitals offering services to individuals on a fee for service basis, allowing providers to
price discriminate
Price discrimination (differential pricing, equity pricing, preferential pricing, dual pricing, tiered pricing, and surveillance pricing) is a microeconomic pricing strategy where identical or largely similar goods or services are sold at diffe ...
based on the health of their patients. With the growth of the American healthcare system after the early 19th century, patient-centered outcomes began to become more of a focus within the healthcare community. In 1978, The Declaration of Alma-Alta was created as the first international declaration of primary healthcare's role in promoting the health of all people.
Later, in 2001, the
Institute for Healthcare Improvement
A patient safety organization (PSO) is an organization that seeks to improve medical care by advocating for the reduction of medical errors. Common functions of patient safety organizations include health care data collection, reporting and a ...
released its six aims for changing healthcare, citing patient-centered healthcare as its third aim.
Patient Protection and Affordable Care Act
Following the publishing of the six aims, President
Barack Obama
Barack Hussein Obama II (born August 4, 1961) is an American politician who was the 44th president of the United States from 2009 to 2017. A member of the Democratic Party, he was the first African American president in American history. O ...
signed the
Patient Protection and Affordable Care Act
A patient is any recipient of health care services that are performed by healthcare professionals. The patient is most often ill or injured and in need of treatment by a physician, nurse, optometrist, dentist, veterinarian, or other health ...
into law. The
Patient Protection and Affordable Care Act
A patient is any recipient of health care services that are performed by healthcare professionals. The patient is most often ill or injured and in need of treatment by a physician, nurse, optometrist, dentist, veterinarian, or other health ...
had three primary goals, to make health insurance affordable and available to more people, to expand the
Medicaid
Medicaid is a government program in the United States that provides health insurance for adults and children with limited income and resources. The program is partially funded and primarily managed by U.S. state, state governments, which also h ...
to cover more individuals, and to support innovative medical care delivery methods that would lower the costs of health care. With these changes, there was a significant increase in the popularity of the push towards patient-centered healthcare. The Affordable Care Act's federal
incentive program
An incentive program is a formal scheme used to promote or encourage specific actions or behavior by a specific group of people during a defined period of time. Incentive programs are particularly used in business management to motivate employees ...
s put emphasis on value-based reimbursement. These programs, along with the basic increase in volume of patients that entered the healthcare system under the ACA, put an increased emphasis on patient-centered outcomes and consumer experiences.
Key Outcomes
In 2014, the
Institute Of Medicine
The National Academy of Medicine (NAM), known as the Institute of Medicine (IoM) until 2015, is an American nonprofit, non-governmental organization. The National Academy of Medicine is a part of the National Academies of Sciences, Engineerin ...
(IOM) published six dimensions of patient-centered healthcare that they deemed as essential in producing quality healthcare. These six dimensions are:
* Safe: Avoid harm to patients.
* Effective: Provide services based on sound scientific knowledge to patients who could benefit from such services and refrain from providing services to patients that may not benefit them.
* Patient-centered: Care that is respectful to the patient's values, needs, concerns.
* Timely: Reduce delays in patient care that may be harmful to the patient's overall well-being.
* Efficient: Avoid waste of services and resources.
* Equitable: Provide care to all patients that is of equal quality that does not vary based on an individual's race, ethnicity or other personal characteristics.
The overall goal of a patient-centered outcome approach to healthcare is the focus on an individual's specific healthcare needs taking into account the patient's own goals in treatment alongside the provider's best clinical expertise in the topic as a medical professional. While it is important to have members of a multidisciplinary healthcare team that have the best training and knowledge caring for the patient, it is also essential that the patient themselves to actively communicate and be vocal about their values and concerns. Healthcare professionals should be using language that the patient can understand and should educate and inform their patients on all decisions made concerning their health. Additionally, researchers seeking to provide evidence to positively guide effective patient-centered decision-making need to ensure standards to prevent missing data that can result in challenges to the integrity of the studies that produce the guidelines themselves.
Cost-Effective Care in the United States
The United States pays more in healthcare expenditure per capita than any other country. Healthcare expenditures the United States accounts for approximately 16% of the country's
gross domestic product
Gross domestic product (GDP) is a monetary measure of the total market value of all the final goods and services produced and rendered in a specific time period by a country or countries. GDP is often used to measure the economic performanc ...
and per capita spending on healthcare is more than twice that of other
developed nations. Given these statistics, healthcare in the United States is no better than in other countries, with the more than 50 million people
uninsured and astronomical healthcare prices and expenditures.
Much of what accounts for the high expenditures is the fact that a large percentage of money going into healthcare is put towards wasteful or unnecessary expenses. Examples of these non-economical expenditures include excessive administrative costs, fraud, and abuse within the healthcare system (both among providers and patients), and misallocated treatments and procedures.
This misuse of funds jeopardizes providers to offer the best services to their patients and leaves reduced funds for research into developing new diagnostic and treatment technologies. Abuse of healthcare funds in the United States is a barrier that patient-centered outcomes face as it diverts funds from healthcare professionals who are dedicated to promoting the idea of patient-centered healthcare.
See also
*
Interactive patient care
*
Patient-Centered Outcomes Research Institute (PCORI)
* ''
The Patient: Patient Centered Outcomes Research''
References
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Health care quality