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

Authors
John H. Wasson
Laura Soloway
L. Gordon Moore
Paul Labrec
Lynn Ho
Peer-Reviewed Article
January 2018

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.
Posted to The Playbook on
Level of Evidence
Promising
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