The Whole PERSON Health Score: A Patient-Focused Tool to Measure Nonmedical Determinants of Health

预期寿命 医疗保健 健康的社会决定因素 多学科方法 医学 卫生公平 社会经济地位 干预(咨询) 老年学 护理部 心理学 环境卫生 人口 公共卫生 社会学 经济增长 经济 社会科学
作者
Dhruv Khurana,Geoffrey Leung,Bijan Sasaninia,Diep Tran,Mahbuba Khan,Anthony Firek
出处
期刊:NEJM catalyst innovations in care delivery [New England Journal of Medicine]
卷期号:3 (8) 被引量:4
标识
DOI:10.1056/cat.22.0096
摘要

SummaryThe development of a plan to deliver health care in America often ignores the nonmedical deficits in patients' socioeconomic resources, well-being, and quality of life, all of which contribute to patient dissatisfaction, poor clinical outcomes, and higher health care costs and utilization. Social determinants of health have been recognized as significant contributors to health, well-being, and, ultimately, longevity, but have been largely unaddressed in primary care because clinicians lack the tools and training to incorporate them while delivering routine care. Riverside University Health System developed a novel and holistic patient-centered assessment tool named the Whole PERSON Health Score (WPHS) to address these critical needs. This article discusses the framework involved in developing, implementing, and evaluating the WPHS in a multidisciplinary, primary care, safety-net setting. The assessment tool consists of 28 questions (or elements) across six domains of health (one for each letter in the PERSON score [Physical Health, Emotional Health, Resource Utilization, Socioeconomics, Ownership, and Nutrition and Lifestyle]) that were chosen on the basis of a literature review of factors that affect lifespan, mortality, and longevity. The patient receives a letter grade ranging from A (the best) to Z (the worst) in each domain. The A–Z letter assignment is not based on a normalized calculation. Rather, letter assignment is based on anticipated impact on life expectancy. The grades are classified into three colors — red, yellow, and green — on the basis of the severity of the intervention needed. This color-coding system highlights the areas of critical need and prompts the provider to engage with the patient to act. Riverside administered 10,166 WPHS assessments from August 2020 to October 2021, out of which 9,809 were completed, representing 8,829 unique patients. In this article, analysis focuses on the 7,926 unique patients who completed a single assessment, to avoid any confusions pertaining to longitudinal analysis. Overall, the greatest need was in the Nutrition and Lifestyle domain (15.22% of the patients assessed, but 49.79% of all red-zone triggers). That domain was followed by Emotional Health (10.59% of patients, 34.64% of red-zone triggers), and Socioeconomics (9.35% of patients, 30.59% of red-zone triggers). In contrast, the least-triggered need for intervention was the Physical Health domain (1.35% of patients, 4.42% of red-zone triggers). On the basis of a provider survey, the value of the WPHS in providing care differed by discipline. The value was greatest for the Probationer Care Management team, which focuses on the needs of recently released probationers (84.61%), followed by the Behavioral Health integration team (66.67%), the Complex Care Management team (50%), and the Primary Care team (44.82%). The WPHS nudges health care teams to prioritize nontraditional upstream patient needs, including emotional health, ownership, and social determinants of health. Completing the WPHS assessment did lead to a recognition of the nonmedical needs of the patient.

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
拾壹完成签到,获得积分10
4秒前
雪花完成签到,获得积分10
6秒前
清风完成签到 ,获得积分10
6秒前
雪花发布了新的文献求助10
10秒前
秀丽笑容完成签到 ,获得积分10
14秒前
江湖应助聪慧芷巧采纳,获得10
15秒前
量子星尘发布了新的文献求助10
16秒前
Rjy完成签到 ,获得积分10
22秒前
性感母蟑螂完成签到 ,获得积分10
28秒前
ruochenzu完成签到,获得积分10
30秒前
陈尹蓝完成签到 ,获得积分10
31秒前
天道酬勤完成签到,获得积分10
33秒前
35秒前
仁爱的谷南完成签到,获得积分10
35秒前
雯雯完成签到 ,获得积分10
37秒前
一路有你完成签到 ,获得积分10
37秒前
38秒前
ruochenzu发布了新的文献求助10
38秒前
40秒前
wanghao完成签到 ,获得积分10
41秒前
图图发布了新的文献求助10
41秒前
十三完成签到 ,获得积分10
41秒前
聪慧芷巧完成签到,获得积分10
42秒前
米博士完成签到,获得积分10
43秒前
研友_VZGVzn完成签到,获得积分10
44秒前
Cheung2121发布了新的文献求助30
45秒前
黄芩完成签到 ,获得积分10
46秒前
1分钟前
秋半梦完成签到,获得积分10
1分钟前
李爱国应助科研通管家采纳,获得10
1分钟前
科研通AI2S应助科研通管家采纳,获得10
1分钟前
搜集达人应助科研通管家采纳,获得10
1分钟前
打地鼠工人完成签到,获得积分10
1分钟前
彩色半烟完成签到,获得积分10
1分钟前
量子星尘发布了新的文献求助10
1分钟前
Ning完成签到,获得积分10
1分钟前
图图完成签到,获得积分10
1分钟前
勤奋的灯完成签到 ,获得积分10
1分钟前
ludong_0完成签到,获得积分10
1分钟前
Asumita完成签到,获得积分10
1分钟前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Handbook of Industrial Diamonds.Vol2 1100
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038066
求助须知:如何正确求助?哪些是违规求助? 3575779
关于积分的说明 11373801
捐赠科研通 3305584
什么是DOI,文献DOI怎么找? 1819239
邀请新用户注册赠送积分活动 892655
科研通“疑难数据库(出版商)”最低求助积分说明 815022