School for Public Health and Primary Care
Placement: Stanford University
Mentor: Sara Singer, Ph.D., M.B.A. (Professor of Medicine, Division of Primary Care and Population Health, Stanford University Medical Center)
Project: Meeting Patient Needs for Care Integration: How to Leverage Opportunities and Break Down Barriers
Maike Tietschert, Ph.D., M.Sc., is a 2017-18 Dutch Harkness Fellow in Health Care Policy and Practice. She recently completed her doctoral studies in Maastricht University’s Department of Health Services Research under a grant from The Netherlands Organization for Scientific Research Graduate Program. Tietschert’s research focuses on evaluating and improving integrated care from the patient’s perspective and she has special interest in facilitating cross-country and cross-cultural learning. She has contributed to guidelines for translating, adapting and validating surveys that measure patient experiences of integrated care for cross-cultural use. Working with researchers at the Harvard T.H. Chan School for Public Health and Maastricht University, she successfully adapted and validated the Patient Perception of Integrated Care (PPIC) Survey for use in the Netherlands. Tietschert is also part of a Harvard-based research team that is looking at how to distinguish high- and low-performing physician organizations based on patient perceptions of care. She has taught on topics related to strategic management, research methods and patient logistics, and served as the Ph.D. Representative for Maastricht University’s Care and Public Health Research Institute at Maastricht University. Tietschert obtained her Master’s of Science degree in Health Policy, Innovation and Management cum laude from the Care and Public Health Research Institute at Maastricht University.
Project Abstract: The United States and the Netherlands are among the countries spending the highest percentage of gross domestic product on health care. The growing number of patients with multiple chronic conditions and complex health care needs increasingly require the healthcare systems in both countries to improve care integration, and as such, reforms that drive the imperative for integration have been introduced. These reforms seek to decrease financial silos and fragmentation through increased provider accountability for quality and costs of care, and prepare medical professionals to treat patients with complex needs. While changing incentives necessitate integrated healthcare delivery models for the high-need high-cost populations that are most vulnerable to poor quality care, many healthcare organizations do not yet have a clear view of how to successfully operate under these new models.
This research aims to (1) compare strengths and weaknesses in care integration as perceived by patients in the U.S. and Netherlands; (2) understand patient needs related to care integration that are not yet met; and (3) identify the contextual factors and mechanisms that enable high-performing initiatives to successfully integrate care, address weaknesses, and maximize strengths in current systems. The study will combine quantitative data analysis, qualitative interviews, and a multiple case study approach.