Why Add "Abolition" to the National Academies of Sciences, Engineering, and Medicine's Social Care Framework?

Abundant evidence demonstrates that enduring, endemic racism plays an important role in determining patient health. This commentary reviews a patient case about disease self-management and subsequent health outcomes that are shaped by social and economic circumstances. We analyze the case using a framework for social care developed in 2019 by the National Academies of Sciences, Engineering, and Medicine (NASEM).

Health And Human Services Integration: Generating Sustained Health And Equity Improvements.

Concurrent increases in evidence about social determinants of health and the use of value-based health care incentives are driving new efforts to integrate health care and human services. Despite expectations that the integration of these complementary services could improve health, reduce health inequities, and reduce potentially avoidable health care use and costs, current evidence on the effectiveness, implementation, and sustainability of such cross-sectoral partnerships is sparse and mixed. To realize the potential of health care and human services integration, knowledge gaps in these key areas must be filled.

Patient Engagement In Health Care Safety: An Overview Of Mixed-Quality Evidence.

Patients and caregivers play a central role in health care safety in the hospital, ambulatory care setting, and community. Despite this, interventions to promote patient engagement in safety are still underexplored. We conducted an overview of review articles on patient engagement interventions in safety to examine the current state of the evidence.

Uses and Misuses of Patient- and Neighborhood-level Social Determinants of Health Data.

Health care leaders in the US are actively exploring strategies to identify and address patients' social and economic hardships as part of high-quality clinical care. The result has been a proliferation of screening tools and interventions related to patients' social determinants of health, but little guidance on effective strategies to implement them. Some of these tools rely on patient- or household-level screening data collected from patients during medical encounters.

Continuity of Care in Residency Teaching Practices: Lessons from "Bright Spots".

Continuity of care is a challenge in primary care residency teaching clinics. Resident physicians have competing inpatient and outpatient responsibilities and often spend only 1 to 2 half-days per week in the clinic. Their clinic schedules are often pieced together after the needs of inpatient and specialty rotations are met.

The Unmet Challenge of Medication Nonadherence.

Medication nonadherence for patients with chronic diseases is extremely common, affecting as many as 40% to 50% of patients who are prescribed medications for management of chronic conditions such as diabetes or hypertension. This nonadherence to prescribed treatment is thought to cause at least 100,000 preventable deaths and $100 billion in preventable medical costs per year. Despite this, the medical profession largely ignores medication nonadherence or sees it as a patient problem and not a physician or health system problem.

Transitions Clinic Network: Challenges And Lessons In Primary Care For People Released From Prison.

Low-income and minority communities are disproportionately affected by incarceration, which exacerbates health disparities. Through enhanced primary care, the Transitions Clinic Network (TCN) seeks to improve the health of people with chronic conditions who return to their communities from prison. Using TCN data, we assessed the impact of early engagement in primary care and referral from correctional systems to TCN on the use of acute care (emergency department visits and hospitalizations) and recidivism.

Integrating Social And Medical Data To Improve Population Health: Opportunities And Barriers.

Recent efforts in medical settings to identify social determinants of health have focused primarily on screening for the purpose of improving care for individual patients and getting standardized data into electronic health records (EHRs). Relatively little attention has been given to processes needed to extract data on social determinants of health out of medical records with adequate validity and efficiency to facilitate analysis across individual encounters to inform population health efforts relevant to the health care sector. In this article we describe the rationale for extracting data on social determinants of health from EHRs, including the potential influence of aggregated data on quality improvement activities and health care payment reform.

The panel management questionnaire: a tool to measure panel management capability.

Primary care practices are turning toward team-based strategies such as panel management, in which nonclinicians address routine preventive and chronic disease care tasks for a group of patients. No known validated instruments have been published for measuring panel management implementation. The authors developed the 12-item Panel Management Questionnaire (PMQ) measuring 4 domains.

San Francisco children living in redeveloped public housing used acute services less than children in older public housing.

Understanding the links between housing and health is increasingly important. Poor housing quality is a predictor of poor health and developmental problems in low-income children. We examined associations between public housing type and recurrent pediatric emergency and urgent care hospital visits.

Use of a modified reproductive life plan to improve awareness of preconception health in women with chronic disease.

Objective: Chronic diseases such as hypertension, diabetes, and obesity pose unique reproductive challenges for women. Preconception health results in improved reproductive outcomes. We designed an interventional study testing the use of a reproductive life plan to improve knowledge of preconception and contraception health in women with chronic diseases.