Patient-Centered Care and Healthcare Disparities

Patient-Centered Care

The American Heart Association recommends patient-centered outcomes, assessment and promotion of patient well-being, and shared decision-making with focus on quality of life outcomes 1
Patient health status surveys should be incorporated into national surveillance of heart disease and stroke to ensure comprehensive assessment of cardiovascular health and treatment impacts 1

The American College of Cardiology notes that the Affordable Care Act has established essential health benefits that include "rehabilitative and habilitative services and devices," which can significantly improve access to services like cardiac rehabilitation for low-income and underinsured populations 2, 3
Cardiac rehabilitation/secondary prevention programs should be reengineered to include a wide array of service options that meet individual patient needs, providing more flexible programs within and beyond traditional clinical centers 3

The American Heart Association suggests that CR/SPP referral, enrollment, program design, and adherence strategies should specifically target older patients, women, minorities, those with low socioeconomic status, individuals with lower education levels, and non-English speakers 3
Having health insurance, a regular physician, and a regular source of usual care are all associated with receipt of preventive health care and higher cancer screening rates, according to the American Cancer Society 4

The American Diabetes Association recommends that quality-enhancing policies should include service referrals as "core" quality-of-care measures for hospitals with public reporting of each hospital's adherence to performance measures 3
Social determinants of health are well-documented as influencing health inequities, and healthcare systems should assess food insecurity, housing insecurity/homelessness, financial barriers, and social support when making treatment decisions, as suggested by the American Diabetes Association 5

The American Diabetes Association notes that the cost of medications, particularly insulin, remains an ongoing barrier to achieving treatment goals, with up to 25% of patients prescribed insulin reporting cost-related underuse 5
Patients who have either private or public insurance coverage are more likely to meet quality indicators for care, according to the American Diabetes Association 5

The implementation of health status measurement in disease surveillance faces challenges related to reliability and validity across populations and cultures, as noted by the American Heart Association 1
Despite scientific evidence supporting benefits of services like cardiac rehabilitation, there remains a wide treatment gap in clinical implementation of such programs, according to the American College of Cardiology 2

Care teams should avoid therapeutic inertia and prioritize timely and appropriate intensification of lifestyle and/or pharmacologic therapy for patients who have not achieved recommended targets, as recommended by the American Diabetes Association 5
Building engagement through nationally adopted frameworks that outline plans to support welfare and protection is a powerful tool to ensure sustainability of processes to prevent institutionalization, enhance quality of alternative care, and preserve families, according to the Lancet Child and Adolescent Health 7