检查与健康相关的社会需求和与外部合作伙伴的合作在美国医院中
Jason J Ashe1, Matthew C Baker1, Carla S Alvarado1
1Association of American Medical Colleges, Washington, District of Columbia.
JAMA network open
|August 23, 2023
概括
大多数美国医院对患者进行健康相关社会需求 (HRSN) 查. 基于价值的医疗保健,教学医院和非营利性医院的医院在解决健康的社会决定因素 (SDOH) 方面显示出更高的查和伙伴关系率.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 公共卫生 公共卫生
- 健康 公平 卫生 公平
背景情况:
- 医院越来越多地对社会需求进行查,但与健康相关的社会需求 (HRSNs) 和健康的社会决定因素 (SDOH) 的查和干预的国家数据有限.
- 了解医院实践的格局对于解决健康差异至关重要.
研究的目的:
- 评估医院特征和区域级社会经济指标与医院的查实践,干预措施和HRSN和SDOH的外部伙伴关系之间的关联.
- 量化医院在解决患者社会需求方面的参与程度.
主要方法:
- 使用2020年美国医院协会年度调查数据库进行的横截面研究.
- 包括通用服务,急症护理,非联邦的美国医院.
- 分析了8个HRSN的医院查数据,8个HRSN的策略和14种外部伙伴关系类型,使用回归分析来检查具有组织特征的关联.
主要成果:
- 大多数医院 (79.2%) 选至少一个HRSN,通常是粮食不安全和人际暴力.
- 大多数医院 (79.4%) 有解决HRSN的策略,其中交通障碍是共同关注点 (52.8%).
- 参与问责护理合同 (ACC) 和捆绑支付计划 (BPP),教学医院和非营利性医院的医院报告了与HRSN和SDOH相关的显著更高的查,干预和合作活动.
结论:
- 大多数美国医院都在积极选和处理患者的HRSN.
- 基于价值观的护理参与 (ACC,BPP),教学地位和非营利地位是全面的社会需求查和干预努力的关键驱动力.
- 这些发现突出了金融激励和组织结构对医院内推进健康公平倡议的影响.
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