PRIME TIME: Study seeks better healthcare for older adults

PHOTOGRAPHER: Kelly de la Rocha

A local professor has received funding for a study that could help make navigating the health care system easier for older adults.

Timothy Hoff, associate professor of health policy and management at the University of Albany School of Public Health, received a $100,000 research grant in September from the Agency for Healthcare Research and Quality. The money will fund research into patient-centered medical home care — a type of care that harkens back to the days when patients had one doctor who knew them well and coordinated all of their medical needs.

A psychologist and public policy expert, Hoff will specifically study how the patient-centered medical home care system can best meet the needs of older adults, a population that typically has more complex medical needs.

Q. What are the major issues that older adults face when it comes to health care?

A. Issues of care coordination are really big between primary care [physicians] and specialists, particularly for older adults who have multiple chronic diseases and need the care for these chronic diseases coordinated. Another [problem] involves issues of access. How do we make sure that older adults, particularly ones that may be more frail or have issues around transportation … are getting to the doctor, particularly the primary care doctor, and getting their care managed and coordinated? [A third challenge involves] issues of assessment — making sure that older adults are not suffering from things that we don’t know about — making sure that they’re getting in to see their doctors and being properly assessed for things like depression or dementia.

Q. Can you explain how patient-centered medical home care works?

A. It’s basically a vision of health care delivery, particularly primary care delivery … that gets back to the traditional notion of having a primary care doctor and practice that take care of you and coordinate your care and manage your care. It’s basically trying to move the patient more into the center of health care in terms of emphasizing what they want and what their needs are. It’s being pitched as a patient-friendly sort of model of health care, and given that we have such a fragmented system, a lot of people have sort of said that it’s a good idea.

Q. How prevalent is patient-centered medical home care?

A. It’s becoming more prevalent, but I would say it’s still more in a more experimental stage nationally, where you have more of the very large primary care delivery systems that may be doing it. But it’s starting to be implemented quicker and quicker in the health care [system] both statewide and across the nation.

Q. How will you conduct your study?

A. My study is actually going to go out and talk with doctors and nurses who are doing medical home care in the community, and basically we’re going to try to talk to them about their experiences delivering that care to their older adult patients and what have they learned that we may be able to take back and put into a sort of revised medical home care model for older adults.

Q. Is there much research of this type going on?

A. The research right now on medical homes (primary care medical practices that coordinate a patient’s care) nationally is sort of in a fledgling stage because the model is so new. There is not a ton out there. … The early research does show some promise, although it also shows that it’s a difficult model to implement.

Q. How do you think your findings could benefit older adults?

A. What I’m hoping is that for the older adult population we can learn things from the practitioners who are doing medical home care for this group and that early on in the patient-centered medical home model we can tweak the model so that it can be more effective and people — both patients and providers — will have a better experience with it.

Q. How could patient-centered medical home care make older patients feel more connected to the health care system?

A. For older adults who might remember primary care when it used to be really about having the same doctor that you had for years and years, it’s about trying to return a little bit to that bygone era where you have a primary care physician and a primary care practice that really knows who you are and takes care of coordinating your needs.