• Barbara G Bokhour, Rian DeFaccio, Lauren Gaj, Anna Barker, Christine Deeney, Scott Coggeshall, Hannah Gelman, Stephanie L Taylor, Eva Thomas, and Steven B Zeliadt.
• Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA, USA. Barbara.Bokhour@va.gov.
• J Gen Intern Med. 2024 Jan 1; 39 (1): 849484-94.

BackgroundWhole Health (WH) is a patient-centered model of care being implemented by the Veterans Health Administration. Little is known about how use of WH services impacts patients' health and well-being.ObjectiveWe sought to assess the association of WH utilization with pain and other patient-reported outcomes (PRO) over 6 months.DesignA longitudinal observational cohort evaluation, comparing changes in PRO surveys for WH users and Conventional Care (CC) users. Inverse probability of treatment weighting was used to balance the two groups on observed demographic and clinical characteristics.ParticipantsA total of 9689 veterans receiving outpatient care at 18 VA medical centers piloting WH.InterventionsWH services included goal-setting clinical encounters, Whole Health coaching, personal health planning, and well-being services.Main Outcome MeasuresThe primary outcome was change in pain intensity and interference at 6 months using the 3-item PEG. Secondary outcomes included satisfaction, experiences of care, patient engagement in healthcare, and well-being.Key ResultsBy 6 months,1053 veterans had utilized WH and 3139 utilized only CC. Baseline pain PEG scores were 6.2 (2.5) for WH users and 6.4 (2.3) for CC users (difference p = 0.028), improving by - 2.4% (p = 0.006) and - 2.3% (p < 0.001), respectively. In adjusted analyses, WH use was unassociated with greater improvement in PEG scores compared to CC - 1.0% (- 2.9%, 1.2%). Positive trends were observed for 8 of 15 exploratory outcomes for WH compared to CC. WH use was associated with greater improvements at 6 months in likelihood to recommend VA 2.0% (0.9%, 3.3%); discussions of goals 11.8% (8.2%, 15.5%); perceptions of healthcare interactions 2.5% (0.4%, 4.6%); and engagement in health behaviors 2.2% (0.3%, 3.9%).ConclusionThis study provides early evidence supporting the delivery of WH patient-centered care services to improve veterans' experiences of and engagement in care. These are important first-line impacts towards the goals of better overall health and well-being outcomes for Veterans.© 2023. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.

11 keywords...

hide…