Roger G. Kathol, MD; Mary H. Kathol, MD
Potential Conflicts of Interest: The authors own a health complexity and physical and mental health integration medical management company.
Kathol RG, Kathol MH. The Need for Biomedically and Contextually Sound Care Plans in Complex Patients. Ann Intern Med. 2010;153:619-620. doi: 10.7326/0003-4819-153-9-201011020-00018
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Published: Ann Intern Med. 2010;153(9):619-620.
TO THE EDITOR:
Weiner and colleagues (1) provide evidence that error-free treatment plans are rarely created for patients with biomedical and contextual complexity (9%) and are not commonly created for those with contextual (22%) or biomedical (38%) complexity alone. This is not surprising given that primary care physicians are already expected to devote 1.5 times their available patient contact hours to providing preventive, long-term care, and acute medical services (2). Nonetheless, implementing improved skills in error-free or, at least, error-reduced care plans for the complex 1% to 5% of patients who use one quarter to one half of health resources (3) will be essential for patient-centered medical homes and accountable care organizations to succeed in augmenting quality care and lowering health-related costs (4). Barriers to improvement in these most needy patients, whose care is expensive, can be removed only through consistent identification and outcome-changing intervention, including contextual life-situation support.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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