A Case Western Reserve University survey of nearly 400,000 patients 65 and older found that they valued continuing social activities with their friends over other considerations when making decisions about their healthcare.
The findings were unexpected, said Mary Dolansky, study co-leader and professor in the Frances Payne Bolton School of Nursing.
"We were surprised, I think, because we figured they would say [maintaining their physical] health, right? They're in a healthcare clinic to get something fixed," she said. "But it wasn't. It was really that they want to stay active and be socially active."
The research, published in the October 6 issue of JAMA Network Open, surveyed 388,000 people across 35 states, asking, "what matters most to you" when determining healthcare priorities among five options: social activities and inclusiveness; health; family togetherness; independence; and other.
Nearly half of all participants, 48.6%, chose social activities and inclusiveness as their top priority for their care.
The results can give doctors a more effective way to talk to their patients about health problems, Dolansky said.
“It's more holistic care delivery rather than just seeing that patient as a disease state," she said. "Here's the way to manage this medication better so that you can still continue with your social activities.”
But that requires an approach that's more time-intensive, Dolansky said.
“I believe that time is necessary to deliver relationship-based care," she said. "That's what we need today. We need to build relationships and not be rushed in our visits with our physicians and providers.”
Providers have an incentive to provide more focus on older adults' priorities as the Centers for Medicare and Medicaid Services (CMS) announced a 2025 rule requiring hospitals that participate in Medicare inpatient quality reporting seek patient health care goals. Hospitals that decline to participate in the program face reductions in their annual Medicare reimbursements.
CWRU researchers will next focus on whether patients engage in follow-up care with their primary care provider or a specialist after the initial visit and what the outcomes look like, said study co-leader Nicholas Schiltz, assistant professor in the in the Frances Payne Bolton School of Nursing.
"For instance, if a clinician at MinuteClinic identifies that a patient is on a high-risk medication and recommends a follow-up with their primary care physician, we want to evaluate whether the patient follows through with this recommendation," he said. "Additionally, we are examining whether such follow-up leads to changes in medication and, consequently, to a reduction in falls."
