健康不平等的信号:在一个大型卫生系统中检查社会需求和成本
Kevin P Fiori1, Samantha R Levano, Silvie Colman
1Author Affiliations: Department of Pediatrics (Dr Fiori, Mss Levano, Haughton, and Lemberg, Dr Telzak, Mr Sirois, and Dr Racine), Department of Family and Social Medicine (Dr Fiori, Mss Levano and Haughton, Drs Chambers and Telzak, Mr Sirois, and Dr Stark), Department of Medicine (Dr Stark), Albert Einstein College of Medicine, Bronx, New York; Office of Community & Population Health, Montefiore Health System, Bronx, New York (Dr Fiori and Ms Spurrell-Huss); Network Performance Group, Montefiore Medical Center, Bronx, New York (Dr Colman); and Department of Financial Planning and Analysis, Montefiore Health System, Bronx, New York (Mr Oliveira).
与健康相关的社会需求 (HRSN) 患者每年承担的医疗保健费用更高. 那些至少有一个HRSN的人每年比没有HRSN的人多花费1772美元,这突显了健康的社会决定因素对财务的影响.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 健康的社会决定因素
- 医疗保健经济学 医疗保健经济学
背景情况:
- 健康的社会决定因素 (SDOH) 显著影响医疗保健利用率,成本和患者的治疗结果.
- 之前的研究表明,社会需求与医疗保健支出增加之间存在联系.
研究的目的:
- 根据与健康相关的社会需要 (HRSN) 状态,比较每名患者提供卫生服务的平均年度总成本.
- 量化与患者体验的HRSN数量相关的成本差异.
主要方法:
- 线性回归分析用于比较具有和没有HRSNs的患者之间的成本.
- 使用差异分析 (ANOVA) 基于HRSN的总数来比较成本.
主要成果:
- 与没有 (n=34775) 患者相比,至少有一个HRSN (n=8409) 的患者每年承担的费用高出1772美元 (P < .0001).
- 患有1个HRSN的患者 (n=4222) 的年度费用高出1689美元,而患有2个或2个以上HRSN的患者 (n=4187) 的年度费用高出1856美元,相对于没有HRSN的患者 (P< .0001).
结论:
- 解决与健康相关的社会需求对于管理医疗保健成本至关重要.
- HRSN的存在和数量与每年医疗保健提供成本的增加直接相关.
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