Addressing the Root Cause

Bush, Melanie

doi:10.18043/ncm.79.1.26

Cited by 23 publications

(12 citation statements)

References 4 publications

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“…Other high-income countries already understand the cause and effect. It is time to address the root cause [20]. In addition, scientists on the basis of a study using international databases to search the literature, which is devoted to substantiating the conceptual model of social determinants of health (SDH) proved that reduction of socioeconomic inequalities in health requires understanding of mechanisms and causal pathways; therefore, every country needs to design the specific model.…”

Section: Discussion Of Research Resultsmentioning

confidence: 99%

Comparative analysis of indicators that determine the effectiveness of the implementation of socio-economic determinants of health in Europe and Ukraine

Kotvitska

Volkova

Korzh

et al. 2021

SR: PS

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The introduction of national strategies aimed at improving the well-being of the population of the country is one of the current approaches to reforming the public policies of the countries of the world. It is the socioeconomic determinants of health that determine the conditions in which people are born, grow, live and getting old, as well as the spheres of influence on these conditions, such as public policy, state of economic development, demographic trends, etc. The aim. In this way, our research has focused on a comparative analysis of macroeconomic indicators that determine the effectiveness of socioeconomic determinants of healthсare in Europe and Ukraine, that are used to provide scientific justification for the construction of humanistic models for the provision of pharmaceutical care to the population in the context of the rapid stratification of Ukrainian society according to socioeconomic indicators. Materials and methods. The research methodology is based on the principles of systems analysis and an interdisciplinary scientific and systemic approach. The study used the empirical method, the method of comparative analysis and synthesis of statistical data, the graphical method. Results. A comparative analysis of the socioeconomic determinants of health in the countries of the European region and in Ukraine was carried out on three levels of indicators: the level of health-care expenditure, the structure of health-care expenditure and expenditure on medicines. The analysis revealed that in 2019, the average health expenditure of the countries analyzed was 8.2 % of GDP. Only two of the 34 countries - Ukraine and Turkey - have a rate below the 5 % that recommended by WHO. Public health financing schemes and compulsory health insurance are the main funding mechanisms in all countries, with the exception of Cyprus. Ukraine, Russia, Greece, Latvia and Bulgaria have the largest share of direct costs to patients as a source of health care financing. The results of the analysis of the medicine expenditure indicator as a proportion of total health expenditure showed that the highest level was in Bulgaria (35.4 %), the lowest in Denmark (6.4 %). Overall, five countries have high levels of pharmaceutical expenditures. In most European countries, the cost of purchasing medicines has been found to range from 346 to 619 USD per person per year. The highest value of this indicator from the European region is in Switzerland (894 USD per person), and the lowest is in Ukraine (73 USD). Based on the results of the comparative analysis, the countries were grouped according to key indicators into three categories - high, medium and low. Conclusions. A comparative analysis of key indicators of the socio-economic determinants of health in the country of the European region has been carried out

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Section: Discussion Of Research Resultsmentioning

confidence: 99%

Comparative analysis of indicators that determine the effectiveness of the implementation of socio-economic determinants of health in Europe and Ukraine

Kotvitska

Volkova

Korzh

et al. 2021

SR: PS

View full text Add to dashboard Cite

show abstract

“…In a value-based payment environment, hospitals have the financial incentives to keep people well and out of the hospital and the flexibility to use hospital resources to address the social determinants of health. It is time for hospitals to put resources into prevention and the social and environmental factors that make people sick (1). Nationally, researchers and policy makers are looking for ways for hospitals and partners to combine resources in a more systemic way (14,15).…”

Section: Discussionmentioning

confidence: 99%

“…The 2012 NVRH Community Health Needs Assessment (CHNA) identified poverty as one of the top health priority areas. Poverty, and the symptoms of poverty like inadequate access to healthcare, healthy food, transportation, and education, is a well-documented root cause of poor health (1,2). Low income adults are more likely to suffer difficulties in their daily lives due to chronic illness, while children living in poverty are often left with risk factors that can affect their health throughout their lives (3) Consequently, tackling poverty in the hospital service area became a priority issue for NVRH and its leaders, particularly the CEO.…”

Section: Introductionmentioning

confidence: 99%

Frameworks for Community Impact - Community Case Study

Ruggles

2020

Front. Public Health

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The Affordable Care Act of 2008 placed specific community health needs assessment and community benefit reporting requirements on US not-for-profit hospitals. The requirements are straightforward, but come with no expectation for synergy between the needs assessment and the community benefit spending, no direction on how to design systems to improve community health, and with surprisingly little accountability for improving health outcomes. With the help of diverse community partners, one Critical Access hospital in rural Vermont has successfully linked the needs assessment with community benefit dollars to address upstream contributors of health. In 2014, Northeastern Vermont Regional Hospital lead the creation of NEK Prosper: Caledonia and Southern Essex Accountable Health Community with a mission to tackle poverty as the ultimate root cause of poor health in the region. This article outlines how a hospital community health needs assessment ignited a change in how community partners worked together, aligned organizational strategies, and overcame industry jargon barriers to create regional system change to improve health. And how that same hospital has used community benefit dollars to accelerate action at the community level.

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“…As a result, the $3.8 trillion spent annually on health care in the U.S. has done little to improve outcomes related to social determinants. 4 Left unaddressed, SDoH create barriers to care that lead to poor health and high costs. Among commercially insured populations, individuals negatively impacted by SDoH are more likely to ration or delay care, engage in unhealthy behaviors, and experience diminished physical health and behavioral health, including higher rates of chronic disease.…”

Section: Introductionmentioning

confidence: 99%

Social Determinants of Health Challenges Are Prevalent Among Commercially Insured Populations

Pera

Cain

Emerick

et al. 2021

J Prim Care Community Health

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Objectives: To evaluate the prevalence of social determinants of health (SDoH) factors in a large commercially-insured population and to characterize the prevalence of common conditions (eg, diabetes, behavioral health issues) and addressable health services utilization concerns (eg, lack of preventive care) for which employers offer no- and low-cost benefit programs. Methods: We identified groups with SDoH challenges within a commercially-insured population of 5.1 M through administrative data and self-report. Using medical claims and health assessment data, we identified populations with SDoH needs who had common conditions for which employers often provide no- or low-cost benefit programs (ie, diabetes, behavioral health conditions, high-risk pregnancy, overweight/obesity). Additionally, we sought populations with common addressable health services utilization concerns such as avoidable emergency room visits, lack of preventive care services, or non-adherence to medications. We used univariate analyses to describe the prevalence of SDoH risks in the population of interest. Results: Twenty-seven percent of this commercially-insured population live in a zip code where the median income is at or below 200% of the Federal Poverty Line. Respondents identified cost (55%) and family, school, or work responsibilities (26%) as key barriers to care. ER overutilization rates are higher in lower income zip codes than wealthier zip codes (34% vs 9%) as is the prevalence of diabetes, overweight/obesity, and behavioral issues, and decreased use of preventive services. Fifteen percent of the study population live in a low-access food area. There is considerable variability in access to employer-sponsored resources to address these needs (70% of employers provide behavioral health programs; 63% provide telehealth programs, but only 1% offer healthy food programs and less than 0.5% offer either child care or transportation support programs). Conclusions: Commercially insured populations could benefit from employer-sponsored programs or benefits that address key SDoH barriers such as financial support, healthy food programs, child-care, and transportation.

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Addressing the Root Cause

Cited by 23 publications

References 4 publications

Comparative analysis of indicators that determine the effectiveness of the implementation of socio-economic determinants of health in Europe and Ukraine

Comparative analysis of indicators that determine the effectiveness of the implementation of socio-economic determinants of health in Europe and Ukraine

Frameworks for Community Impact - Community Case Study

Social Determinants of Health Challenges Are Prevalent Among Commercially Insured Populations

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