The implementation cost of a safety‐net hospital program addressing social needs in Atlanta
| Autor: | Diane Wirth, Anekwe Onwuanyi, Matthew McCurdy, John M Chapel, Rashon I. Lane, Jasmin Minaya-Junca, Kara MacLeod |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Social Work
Georgia Outpatient Clinics Hospital Social Welfare Transportation Medication Adherence 03 medical and health sciences 0302 clinical medicine Nursing Ambulatory care Health care Humans 030212 general & internal medicine Social determinants of health Health Education Cost database Retrospective Studies Heart Failure business.industry 030503 health policy & services Health Policy Hospitals and Health Systems Disease Management Home Care Services Health equity Cross-Sectional Studies Socioeconomic Factors Community health Health education Business 0305 other medical science Safety-net Providers |
| Zdroj: | Health Serv Res |
| Popis: | Objective To describe the cost of integrating social needs activities into a health care program that works toward health equity by addressing socioeconomic barriers. Data sources/study setting Costs for a heart failure health care program based in a safety-net hospital were reported by program staff for the program year May 2018-April 2019. Additional data sources included hospital records, invoices, and staff survey. Study design We conducted a retrospective, cross-sectional, case study of a program that includes health education, outpatient care, financial counseling and free medication; transportation and home services for those most in need; and connections to other social services. Program costs were summarized overall and for mutually exclusive categories: health care program (fixed and variable) and social needs activities. Data collection Program cost data were collected using a activity-based, micro-costing approach. In addition, we conducted a survey that was completed by key staff to understand time allocation. Principal findings Program costs were approximately $1.33 million, and the annual per patient cost was $1455. Thirty percent of the program costs was for social needs activities: 18% for 30-day supply of medications and addressing socioeconomic barriers to medication adherence, 18% for mobile health services (outpatient home visits), 53% for navigating services through a financial counselor and community health worker, and 12% for transportation to visits and addressing transportation barriers. Most of the program costs were for personnel: 92% of the health care program fixed, 95% of the health care program variable, and 78% of social needs activities. Discussion Historically, social and health care services are funded by different systems and have not been integrated. We estimate the cost of implementing social needs activities into a health care program. This work can inform implementation for hospitals attempting to address social determinants of health and social needs in their patient population. |
| Databáze: | OpenAIRE |
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