Housing, Transportation, And Food: How ACOs Seek To Improve Population Health By Addressing Nonmedical Needs Of Patients
Housing, Transportation, And Food: How ACOs Seek To Improve Population Health By Addressing Nonmedical Needs Of Patients
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DOI：
10.1377/hlthaff.2016.0727
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发表时间：
2016-11-01
期刊：
影响因子：
9.7
通讯作者：
Fisher, Elliott S.
中科院分区：
文献类型：
--
作者：
Fraze, Taressa;Lewis, Valerie A.;Fisher, Elliott S.
解决非医疗需求，如住房需求，对于促进人口健康、提高医疗质量和降低医疗成本至关重要。问责护理组织（ACO）能够很好地满足这些需求。我们使用定性访谈ACO领导人和现场访问，以检查这些组织如何解决他们的病人的非医疗需求，以及他们这样做的程度。我们开发了一个类型学的医疗和社会服务的整合ACOs，解开服务和组织整合。我们发现，ACO最常解决的非医疗需求是交通、住房和粮食不安全的需求。ACO通过作为初级保健访问或护理转型计划的一部分的过程来确定非医疗需求。满足患者非医疗需求的方法要么是个性化的解决方案（逐个患者制定），要么是有针对性的方法（为满足特定需求而制定的计划）。随着政策制定者继续为医疗保健组织提供激励措施，以满足更广泛的患者需求，这些发现为医疗保健组织（如ACO）如何与非医疗组织整合提供了见解。
Addressing nonmedical needs-such as the need for housing-is critical to advancing population health, improving the quality of care, and lowering the costs of care. Accountable care organizations (ACOs) are well positioned to address these needs. We used qualitative interviews with ACO leaders and site visits to examine how these organizations addressed the nonmedical needs of their patients, and the extent to which they did so. We developed a typology of medical and social services integration among ACOs that disentangles service and organizational integration. We found that the nonmedical needs most commonly addressed by ACOs were the need for transportation and housing and food insecurity. ACOs identified nonmedical needs through processes that were part of the primary care visit or care transformation programs. Approaches to meeting patients' nonmedical needs were either individualized solutions (developed patient by patient) or targeted approaches (programs developed to address specific needs). As policy makers continue to provide incentives for health care organizations to meet a broader spectrum of patients' needs, these findings offer insights into how health care organizations such as ACOs integrate themselves with nonmedical organizations.