August 1, 2019

Social Determinants of Health: New Solutions for Growing Complexities

The World Health Organization describes social determinants of health (SDOH) as the “conditions in which people are born, grow, live, work and age.” Hospital leaders, clinicians, and social services professionals recognize SDOH as the complex, integrated, and overlapping web of social structures and economic systems that our standard methods for delivering and paying for care fail to address.

Around the nation, hospitals and payers are thinking more holistically about their patients, empowering care teams with a broader set of tools to better manage clinical and financial outcomes based on a better understanding of these determinants.

A recent webinar was hosted by Robert Bessler, MD, Chief Executive Officer and Founder of Sound Physicians, and Jeffrey Brenner, MD, who was the focus of Atul Gawande’s landmark article “The Hot Spotters” for his work with medically complex patients in Camden, NJ. They discussed what leaders can do to better equip their clinicians and care teams to holistically help a wide array of patients with complex needs.

Accountability for Managing Patients’ Health and Socioeconomic Needs

According to Dr. Brenner, “The old tools of managed care pre-certification, pre-authorization, formularies, and medical management are running out of steam for sickest, most complex and most expensive patients who get lost in the healthcare system and often don’t get the care that they need.”

“Reimagining care for highest utilizers has become a top priority for hospitals that are focused on total cost of care,” Dr. Bessler observed. “Hospitalists are uniquely equipped to impact post-acute outcomes. And while they don’t need to be experts on social determinants – taking them into consideration can make a big difference.”

A hospitalist working in partnership with a clinical performance nurse can assess a patient’s health and socioeconomic needs, especially for common challenges such as transportation and nutrition. They actively collaborate with case management, nursing, and other care teams to understand goals of care so patients are discharged to the most clinically-appropriate next site of care, and ensure patients and their families connect with the right resources.

Evidence is building that greater investment in addressing the social determinants of health may foster better health without accelerating healthcare costs in America. Reliable transportation, stable housing, and food security play a major role in everyone’s health. Those without access to these the basic resources disproportionately suffer from ailments that spiral to complex medical conditions, ultimately reducing quality of life and life expectancy.

Join the Conversation Around Social Determinants of Health

Share your experiences and insight in our comments thread, and watch a replay of the webinar: Social Determinants of Health: The Underlying Issues Impacting Healthcare Costs and Quality.


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