Pandemic Sparked Family Conversations We All Should Have – The health system exists to serve the most important needs of society: the health and well-being of people. To do this effectively, it requires people to be involved as joint decision-makers in all aspects of the health system and practice. Patients, families and communities represent a diverse group of individuals and communities who struggle with a wide range of health conditions and participate in the health care system for prevention, screening, diagnosis and treatment. But patients, families and communities are not only recipients of health services – they are also partners in scientific research, collaborators in decision making in care and related issues, and advocates for public health priorities for their communities. 2017 National Academy of Sciences, Engineering, and Medicine (NASEM) report.

Share the importance of the community’s role in improving health equity. The report concluded that community-driven approaches are necessary because communities are in a unique position to prioritize and respond to their needs, which address many of the health determinants [179]. In addition, the development of the collaboration of patients, families and communities is encouraged as a strategy for changes in health policy, research and care to improve the quality of care and drive health equity [237]. Bringing the different parts of the health system around the experiences, needs and considerations of patients, families and communities is a very important condition to achieve the values ​​of equity, efficiency and effectiveness.

Pandemic Sparked Family Conversations We All Should Have

Unfortunately, the US health care system has long fallen short of these goals, as shown by increasing health care costs without improvements in public health [234]. In fact, life expectancy in the United States has decreased in recent years, a stark contrast to what is happening in other developing countries [112]. In addition, before the onset of the COVID-19 pandemic, the United States faced other challenges, such as misdiagnosis of patients and medical errors, which lead to thousands of preventable deaths every year [9, 133]. Instead of occupying the center of the health care system, many patients, families and communities have been relegated to the margins as challenges to ensuring community health. Furthermore, long-standing disparities in health status and health outcomes affect communities of color; low-income people; people with disabilities; lesbian, gay, bisexual, transgender and queer (LGBTQ+); people with limited English skills; in adults [164].

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It is during this time of declining health and increasing inequality in the United States that the COVID-19 pandemic has struck. The public health emergency—which is ongoing at the time of this paper’s publication—has a devastating impact on the lives of individual patients, families, and communities across the country and the world. The virus has seriously affected the health of these groups, with 45,655,635,3,223,806 hospitalizations, and 740,348 deaths in the United States by October 27, 2021 [274]. In addition, additional stress from the increase in daily life caused by the disease (manifested by the deterioration of mental health in almost every population) and the disruption of other types of important health services (for example, daily disease management) make it more challenging . for patients, families. , and communities to pursue health and well-being [32, 85, 196]. Overall, the cumulative health effects of COVID-19 led to a full-year decrease in average life expectancy in the United States during 2020.

The outbreak also created racial and class divides in the health care system. Morbidity and mortality attributed to COVID-19 vary across the population in the United States according to age, income, health-related factors (eg, geographic location, education), race, ethnicity, gender and sexual orientation, and immigration status [95, 162] , 191] . For example, the reduction in life expectancy due to COVID-19 was greater for blacks (2.7 years) and Latinx (1.9 years) compared to whites (0.8 years), with the gap between blacks and whites Communities that have the largest size distribution in over two decades [53]. Furthermore, the impact of the disease on populations with diverse and moderate associations (eg low-income rural residents, low-income women, low-income seniors) may be more important, because the groups are more likely . Experience inequality and inequality.

Overall, the negative impact and response to the COVID-19 pandemic highlights weaknesses and inequalities in health conditions and health systems, as well as differences in the factors that significantly affect health and well-being (eg wealth, social). health insurance). However, the pandemic has also given leaders the opportunity to implement effective reforms to ensure health and well-being for all by modernizing the health care system around patients, families and communities and addressing historical legacies and systemic failures in sectors that lead to the contribute to public health. Differences.

This discussion paper aims to provide a comprehensive review of the impact and impact of the COVID-19 pandemic on patients, families and communities (see

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). Essentially, this assessment seeks to provide sector leaders’ perspectives on system failures and opportunities for change, and to highlight the stories and experiences of patients, families and communities who have shown remarkable resilience in the face of the overwhelming impact of COVID. -19. While this assessment focuses more on patients, families and communities, it will address the injustices that exist for marginalized communities, focusing on low-income, communities of color. , and adults and their family caregivers. This paper will highlight the interactions between patients and families, which are made up of communities, and which are linked to the higher health system, as shown in the sociological framework [148]. Identifying the current challenges facing patients, families and communities in the health care system before and during COVID-19 will allow the development of new technologies and interdisciplinary collaboration to achieve meaningful progress.

In recent years, there has been an increased focus on ways to improve patient- and family-centered care, address public health determinants, and improve patient outcomes. However, despite the evidence of positive benefits arising from improved partnerships, patients, families and communities, these changes are few and do not lead to major improvements in public health. Further, patients, families and communities still face significant challenges before the outbreak, including gaps in access to essential services and public health infrastructure and the limitations and consequences of racial discrimination. of structure and institutions. This section presents the progress before the outbreak and the challenges for patients, families and communities (see

Patient-centered care focuses on providing care that respects and responds to patient concerns, needs, and values, and ensures that clinical decisions are guided by patient values ​​[ 128 ]. In recent years, payers, providers and politicians have invested in many ways to increase family involvement in care, which is changing the way care is delivered (eg development of hospitals, medical centers), payment (eg, away from payment for services to alternative payments, development of value-based programs) and measurement (eg, development and use of patient-reported outcome measures) [43, 70]. In addition, integration in care settings has improved effective information sharing, supported the reform of hospital equipment and care systems, encouraged patients to represent themselves at hospitals and health care systems, and promoted changes to old ‘group size [43]. Despite the challenges faced in implementing patient-centered approaches (eg, lack of established guidelines or knowledge of best practices for collaboration), growing evidence shows the benefits of patient-family care, including improved patient health, perceived efficacy, medication adherence, functional. Status and recovery, and rate of medical errors [8, 102, 239].

Substantial evidence describes how determinants of public health, including education, transportation, housing, and access to food, affect patient health outcomes at the population level. In recent years, payers and providers have tried to improve the health system to address the social needs of patients through a collaborative and integrated delivery model [179]. For example, payers are exploring federal protest models such as Health Care Alliances for state efforts to assess and seek social needs through Medicaid care [22, 73]. Similarly, the cooperation of the Ministry of Health conceived and carried out under the guidance of the Public Health 3.0 system and the management system and investments in social services, such as access to safe and affordable housing, compared the efforts of different sectors to solve. the social problems of health that affect patients. , families and communities [123, 190]. Indeed, more work is needed among payers, health systems, and providers, along with patients and community groups, to understand how to gather information about social needs, identify available resources, and support patient use.

Covid 19 Lessons Shaping Our Post Pandemic Future

The voices of patients, families and communities are important for research to ensure that the benefits are accessible to all patients and include the results most relevant to them [198]. Community-based collaborative research models and patient-centered outcomes research—in which patients, families, and communities are considered partners and included in question selection, data ownership, and dissemination of results—represent effective ways to improve the accuracy and benefits of research. [134] Eng. For example, the creation of the Patient Outcomes Research Center (PCORI) appears to reflect continued interest and commitment to effective patient comparison research. The results of PCORI’s research activities on addressing disparities and improving the health system have been translated into applications to address various health and health problems [199].

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