Addressing Health-Related Social Needs: Value-Based Care or Values-Based Care?
Addressing Health-Related Social Needs: Value-Based Care or Values-Based Care?
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DOI：
10.1007/s11606-019-05087-3
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发表时间：
2019-09-01
影响因子：
5.7
通讯作者：
Edwards, Samuel T.
中科院分区：
文献类型：
--
作者：
Berkowitz, Seth A.;Baggett, Travis P.;Edwards, Samuel T.
与健康相关的社会需求，如粮食不安全、住房不稳定和缺乏交通，与更差的健康结果有关，并日益成为医疗保健领域与健康相关的社会需求干预措施的重点。采取与健康有关的社会需求干预措施往往是因为有可能降低医疗保健费用。然而，这可能给临床医生带来难题。医生通常更习惯于证明基于健康改善的临床创新是合理的，这与医学专业的基本价值观雅阁，包括利用我们的知识，技能和我们所掌握的资源来改善个人和公共健康。在与健康有关的社会需求干预措施改善健康但不节省费用的情况下，这两种理由可能相互冲突。我们提供了一个考虑这些问题的框架，并就这一主题的学术工作的议程。最后，如果促进病人和公众健康是我们职业的关键价值，那么了解何时强调基于价值的护理，而不仅仅是基于价值的护理，对于履行我们的职业职责至关重要。
Health-related social needs, such as food insecurity, housing instability, and lack of transportation, are associated with worse health outcomes, and are increasingly the focus of health-related social needs interventions within healthcare. Adoption of health-related social needs interventions is often justified by the potential to reduce healthcare costs. However, this can present a conundrum to clinicians. Physicians are often more accustomed to justifying clinical innovation based on improvements in health, in accord with the fundamental values of the medical profession, which include using our knowledge, skills, and the resources at our disposal to improve both individual and public health. In cases where health-related social needs interventions improve health but are not cost-saving, these two types of justifications can conflict. We provide a framework for considering these issues, and an agenda for scholarly work on this topic. Ultimately, if promoting patient and public health are key values for our profession, then understanding when to emphasize values-based care, rather than simply value-based care, is crucial to fulfilling our professional duty.