An increasing number of hospital patients have complex health problems, such as frail older adults or individuals with multiple long-term conditions (MLTC). Current healthcare is primarily focused on individual diseases, leading patients to see multiple specialists without proper coordination. This fragmentation can result in complications, overtreatment, and lower patient satisfaction. A solution to this issue is patient-centered care.
This thesis of Emma Gans examines two key pillars of patient-centered care for hospital patients with complex health problems: Shared Decision-Making and interdisciplinary collaboration.
The research shows that invasive treatments are often chosen for vulnerable older adults without consulting geriatricians. Additionally, patients with MLTC who see many different specialists in outpatient care are more frequently admitted to the hospital unexpectedly.
The study also highlights the importance of prioritizing patient goals when making appropriate treatment decisions for patients with complex health issues. Decision aids can help older adults in making medical choices, but it remains unclear whether they are equally effective for frail older patients.
Furthermore, collaboration between specialists for patients with MLTC is often unstructured. To address this, this thesis proposes an Interdisciplinary Patient Review, where healthcare providers work together to develop an integrated treatment plan. While this is a crucial step toward better care, challenges such as lack of time, funding, and inefficient information exchange remain obstacles.
In conclusion, healthcare providers must shift from a purely disease-focused approach to patient-centered care. This also requires targeted funding and sufficient time for healthcare providers to implement these practices effectively.