We also fail to take into account someone's #sdoh when developing care plans, raising the price of drugs, coming up with a new app sending seniors home by themselves, or assuming they have healthy food to eat while healing from surgery
FYI (20% of US kids live in poverty)
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On the other hand, I see risks in normalizing poor outcomes in disadvantaged patients.
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Or worse, blame bad health on
#SDOH Determinants aren’t deterministic. -
Ha!
#sdoh Determinants aren’t deterministic!pic.twitter.com/iU2NkYFHQf
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Having moved from a safety-net hospital primary care practice x25 years to an academic hospital primary care practice with middle class patients, SDOH make it much more difficult to delivery high quality care for patients even with the same clinic resources!
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And in the case of
@CMSGov HRRP program heart failure patients paid the ultimate price of increased mortality. It is essential to get these programs modified to account for and adequately adjust for SE factors.@NMHheartdoc@coconnormd@ashishkjha@kejoyntThanks. Twitter will use this to make your timeline better. UndoUndo
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Very thoughtful look at an incredibly difficult problem. Solcial determinants of healthcare can often outweigh the medical issues. We must adress both or we are doomed to failure. I for one will not offer elective surgery when I know the pt has no chance for success. No choice ER
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So glad this is beginning to be recognized by policymakers. Current value-based payment methods minimally take social determinants of health into account. This incentivizes caring for pts most able to adhere to docs’ recommendations rather than pts w/ socioeconomic challenges
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Fortunately
@cityblockhealth here to address this issue!Thanks. Twitter will use this to make your timeline better. UndoUndo
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Social determinants of health (
#sdoh) are often harder to measure and more complex to understand, but must be considered due to their large and relentless impact on health outcomes.Thanks. Twitter will use this to make your timeline better. UndoUndo
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Congrats on your new role
@Atul_Gawande. Glad to see that quality of care provided to patients, especially the most vulnerable, is being introduced into the conversation and reimbursement. Looking forward to the innovative ideas from the new venture.Thanks. Twitter will use this to make your timeline better. UndoUndo
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What if we addressed the socioeconomic barriers that poor people face rather than trying to tweak the P4P playing field?
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Btw I don't know many Docs who are being "hurt financially" by caring for the poor - Ave US doctor makes ~ $300k: year (cardiologist $423) but I do know many patients who go can't afford care. Medscape Physician Compensation Report 2018 https://www.medscape.com/slideshow/2018-compensation-overview-6009667?src=soc_tw_share … via
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It’s about time EMR’s catch up and capture smart data around social determinants of health
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I couldn't agree more,
@Atul_Gawande. We should be measuring social risk in assessing outcomes. And, payers can use social risk information to augment coverage and provide support that targets individual and group social risks. We@Collective make this central in our care models.Thanks. Twitter will use this to make your timeline better. UndoUndo
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One low cost, high impact solution to addressing social determinants of health: community health workers
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Complex topic; we should pay more for care that takes more resources, but we should not allow lax quality standards for those serving disadvantaged groups, entrenching disparities.
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Is there a parallel with how teachers are measured by students progress in public schools? Socio economic factors as well as an unstable home environment seems to have a negative impact on studies. Some common threads perhaps?
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