Many high-need patients missing out on help with ADLs, report shows

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The majority of high-need patients in the United States who require help with activities of daily living do not have enough support, a new report shows.

The Playbook: Better Care for People with Complex Needs, was released Friday by five national healthcare organizations as an “initial effort to to compile and share promising approaches” in improving care for people with complex medical needs. The report includes findings from the 2016 Commonwealth Fund Survey of High-Need Patients, those with two or more major chronic conditions such as stroke or diabetes.

The report found that 57% of high-need survey respondents have trouble with activities of daily living such as eating, bathing and dressing. Of that group, 62% reported that they either rarely or never have someone to help them complete their ADLs. Roughly 75% of high-need respondents who said they did receive help reported that it came from a family member.

The majority of the survey's respondents were adults with multiple chronic conditions, while just over 8% were seniors with multiple functional limitations.

The report's findings also showed that patient-centered communication and access to care helped high-need patients avoid emergency department visits, as well as emotional distress.

“Redesigning care for patients with complex needs, especially disadvantaged older people who interact frequently with our medical system, will alleviate suffering, decrease costs, and send a message that we are serious about health equity,” said Terry Fulmer, president of the John A. Hartford Foundation, one of the organizations behind the Playbook.