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医疗保健上下颠倒:透过SDOH视角的医疗保健

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心电图的 广播节目和播客《云顶集团rt电子游戏》提供了未经过滤的观点 在美国的医疗体系中什么起作用,什么不起作用. 由心电主任博士主持. 尼克 van Terheyden,每一集都有嘉宾小组成员,他们探索 美国医疗体系的利弊,以及如何让这个体系发挥作用 对每个人来说.

考虑到我们在云顶集团rt电子游戏预约上花了大量的钱, 药物, 测试, 程序, 预防活动, 和类似的, it would be reasonable to assume that health护理 玩s an outsize role in our overall health. But by some estimates, medical 护理 only contributes about 20% to our overall health and well-being.

另外的80%? 当然,我们的基因构成是一个主导因素. 但是我们的物理环境, 健康行为, 社会经济地位, 和其他circumstances-collectively, what we call social determinants of health (SDOH)—also 玩 a significant role in our health outcomes.

SDOH的影响延伸到我们生活的大部分方面. 根据美国卫生部的说法 & 人类云顶集团的 健康的人有2030 倡议, SDOH是“人们出生的环境条件”, 生活, 学习, 工作, 玩, 敬拜, 年龄对健康有很大影响, 功能, 以及生活质量的结果和风险.” SDOH factors shed light on why people born a few miles away from one another can experience vast differences in life expectancy—在某些情况下,差异高达25年.

In 鉴于SDOH对人民福祉和健康的深远影响,为什么要这样做 我们没有看到更多旨在解决社区SDOH的项目?

“I think most health护理 organizations do really 护理 about their patients in their community,Veronica Oestreicher说, CSuite3的负责人. “But asking them to step out of the zone of what they’re used to doing is always something that takes time, 结构, 还有一定的舒适程度.”

Health护理 organizations that are willing to step outside of that comfort zone can make a substantial difference in their communities. Health systems may not be able to resolve issues such as food insecurity or housing deprivation, but by 学习ing more about their patients’ environments and facilitating connections with community resources, 它们可以帮助病人走上一条更健康的道路.

“当你和你的云顶集团提供商团队一起工作时, 你希望被看作是一个独立的病人, 看看你生活中所有可能导致健康结果的东西,萨勒姆Hawatmeh解释道, 心电管理顾问公司的经理.

Coauthors of a recently published whitepaper titled “Operational Frame工作 for Addressing Social Determinants of Health,” Salem and Ronnie want to give health systems a roadmap for understanding SDOH and enacting meaningful interventions. 他们认为,解决SDOH问题可以减少总体医疗支出, 减少再入院和不必要的使用, 在所有人口中实现更好的卫生公平.

罗尼和塞勒姆加入我们的第14集《云顶集团rt电子游戏》. 以下是我们谈话的三个要点.

为什么医疗保健组织应该关注SDOH.

Serving in some capacity to mitigate SDOH is a natural step for most health护理 organizations, 因为它建立在他们关心社区的传统之上. 但正如罗尼解释的那样,医疗护理也就到此为止了. “One of the most fascinating studies that I’ve seen on this topic is how much of our health护理 is influenced by factors other than health护理 services,”她说. “社会经济因素、物理环境、健康行为和基因 约占80%. And that’s pretty shocking, when you think that only 20% is what we do in health护理.”

提供更好的护理, 企业尤其需要更多地了解其他80%, 哪些因素可能会阻止他们的病人坚持护理计划. 例如, patients without reliable transportation may be unable to pick up prescriptions; food insecurity may prevent patients from maintaining a consistent and healthy diet.

塞勒姆说:“医疗机构应该把这视为预防性保健。. “当我们谈到上游医疗保健时, 这是油井访问, but it’s also asking patients about things in their 生活s that make up the total patient. 我认为它连接了两点,点A, ask the question and get the answer about those social factors; point B, 将它们与资源连接起来.”

SDOH数据收集的变化.

医疗保健组织当然不会忘记SDOH, and many do ask questions of their patients designed to 学习 more about their environments. “I think a lot of well visits capture parts of the social environment,” Salem says. 但是查询需要更加全面. “在我最近的一次访问中,我记得有人问我多久喝一次酒,是否吸烟. 这些确实考虑到了一些行为项目, 我有合适可靠的交通工具吗? 我是否因为无法控制的原因而错过了约会?”

Ronnie notes that many organizations are stymied by the lack of a standard approach to collecting SDOH data. “There’s no consistency yet in the way we collect the data, and what data we collect,”她说. “It will be a positive development when there are standard questions that all can ask based on facts and evidence.“与此同时, 虽然, Ronnie suggests organizations seek out resources that will help them devise SDOH questionnaires. “I think every 医疗保健组织应该确保这一点,即使他们没有 始终如一,他们在问问题.”

重新考虑投资回报率.

这是云顶集团rt电子游戏领导人提出的一个不可避免的问题,也是一个公平的问题我能从中看到回报吗? 如果云顶集团rt电子游戏投资于获取和编码SDOH数据, 或者在社区中寻求更有雄心的干预措施, 他们能期望什么样的投资回报(ROI)?

Both Salem and Ronnie cite evidence of how SDOH investments can benefit patients and the organizations that serve them. 但这不仅仅是金钱的问题. 可以肯定的是, hospitals stand to reduce readmissions by understanding the factors that are bringing them back to the hospital and helping them adhere to 护理 plans. 但塞勒姆解释说,我们需要区分传统, 财务ROI和一些难以量化的东西——社会ROI.

“There’s the internal organization impact on the organization and the patients themselves,”他说, “然后还有社会或社区的利益. 你只影响你的病人吗, 或者你是在影响你所在的更大的社区?”

“Social ROI is much, much harder to measure than typical ROI,” Ronnie acknowledges. “你如何影响你周围的社区, 无论是减少犯罪, 或者是受过更好教育的人口? 懂得烹饪营养膳食的人——这对健康有何影响? 这就更难计算了.”

But even from a bottom-line perspective, investing in SDOH is proving to show a financial return. 罗尼指着一个 保障性住房项目 由马里兰州的Bon Secours经营. “The social ROI of what they were trying to achieve in terms of helping adults have stable housing, 更好的预防保健云顶集团, 更少的犯罪, 更好的营养表明他们可以节省1美元.30 to $1.每花费一美元就有92美元.”

是时候为您的组织制定SDOH战略了吗?

塞勒姆和罗尼谈论发展SDOH战略, 实施计划, and how employees feel about 工作ing for organizations that invest in corporate social responsibility.

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