The implementation cost of a safety-net hospital program addressing social needs in Atlanta
© 2021 Health Research and Educational Trust. This article has been contributed to by US Government employees and their work is in the public domain in the USA..
OBJECTIVE: To describe the cost of integrating social needs activities into a health care program that works toward health equity by addressing socioeconomic barriers.
DATA SOURCES/STUDY SETTING: Costs for a heart failure health care program based in a safety-net hospital were reported by program staff for the program year May 2018-April 2019. Additional data sources included hospital records, invoices, and staff survey.
STUDY DESIGN: We conducted a retrospective, cross-sectional, case study of a program that includes health education, outpatient care, financial counseling and free medication; transportation and home services for those most in need; and connections to other social services. Program costs were summarized overall and for mutually exclusive categories: health care program (fixed and variable) and social needs activities.
DATA COLLECTION: Program cost data were collected using a activity-based, micro-costing approach. In addition, we conducted a survey that was completed by key staff to understand time allocation.
PRINCIPAL FINDINGS: Program costs were approximately $1.33 million, and the annual per patient cost was $1455. Thirty percent of the program costs was for social needs activities: 18% for 30-day supply of medications and addressing socioeconomic barriers to medication adherence, 18% for mobile health services (outpatient home visits), 53% for navigating services through a financial counselor and community health worker, and 12% for transportation to visits and addressing transportation barriers. Most of the program costs were for personnel: 92% of the health care program fixed, 95% of the health care program variable, and 78% of social needs activities.
DISCUSSION: Historically, social and health care services are funded by different systems and have not been integrated. We estimate the cost of implementing social needs activities into a health care program. This work can inform implementation for hospitals attempting to address social determinants of health and social needs in their patient population.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2021 |
|---|---|
| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:56 |
|---|---|
| Enthalten in: |
Health services research - 56(2021), 3 vom: 04. Juni, Seite 474-485 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
MacLeod, Kara E [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Costs and cost analysis |
|---|
| Anmerkungen: |
Date Completed 03.12.2021 Date Revised 16.07.2022 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1111/1475-6773.13629 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM32140162X |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM32140162X | ||
| 003 | DE-627 | ||
| 005 | 20231225175729.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2021 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1111/1475-6773.13629 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1071.xml |
| 035 | |a (DE-627)NLM32140162X | ||
| 035 | |a (NLM)33580501 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a MacLeod, Kara E |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The implementation cost of a safety-net hospital program addressing social needs in Atlanta |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 03.12.2021 | ||
| 500 | |a Date Revised 16.07.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2021 Health Research and Educational Trust. This article has been contributed to by US Government employees and their work is in the public domain in the USA. | ||
| 520 | |a OBJECTIVE: To describe the cost of integrating social needs activities into a health care program that works toward health equity by addressing socioeconomic barriers | ||
| 520 | |a DATA SOURCES/STUDY SETTING: Costs for a heart failure health care program based in a safety-net hospital were reported by program staff for the program year May 2018-April 2019. Additional data sources included hospital records, invoices, and staff survey | ||
| 520 | |a STUDY DESIGN: We conducted a retrospective, cross-sectional, case study of a program that includes health education, outpatient care, financial counseling and free medication; transportation and home services for those most in need; and connections to other social services. Program costs were summarized overall and for mutually exclusive categories: health care program (fixed and variable) and social needs activities | ||
| 520 | |a DATA COLLECTION: Program cost data were collected using a activity-based, micro-costing approach. In addition, we conducted a survey that was completed by key staff to understand time allocation | ||
| 520 | |a PRINCIPAL FINDINGS: Program costs were approximately $1.33 million, and the annual per patient cost was $1455. Thirty percent of the program costs was for social needs activities: 18% for 30-day supply of medications and addressing socioeconomic barriers to medication adherence, 18% for mobile health services (outpatient home visits), 53% for navigating services through a financial counselor and community health worker, and 12% for transportation to visits and addressing transportation barriers. Most of the program costs were for personnel: 92% of the health care program fixed, 95% of the health care program variable, and 78% of social needs activities | ||
| 520 | |a DISCUSSION: Historically, social and health care services are funded by different systems and have not been integrated. We estimate the cost of implementing social needs activities into a health care program. This work can inform implementation for hospitals attempting to address social determinants of health and social needs in their patient population | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a costs and cost analysis | |
| 650 | 4 | |a evaluation study | |
| 650 | 4 | |a health equity | |
| 650 | 4 | |a hospitals | |
| 650 | 4 | |a social determinants of health | |
| 650 | 4 | |a uninsured/safety net providers | |
| 700 | 1 | |a Chapel, John M |e verfasserin |4 aut | |
| 700 | 1 | |a McCurdy, Matthew |e verfasserin |4 aut | |
| 700 | 1 | |a Minaya-Junca, Jasmin |e verfasserin |4 aut | |
| 700 | 1 | |a Wirth, Diane |e verfasserin |4 aut | |
| 700 | 1 | |a Onwuanyi, Anekwe |e verfasserin |4 aut | |
| 700 | 1 | |a Lane, Rashon I |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Health services research |d 1966 |g 56(2021), 3 vom: 04. Juni, Seite 474-485 |w (DE-627)NLM000017612 |x 1475-6773 |7 nnns |
| 773 | 1 | 8 | |g volume:56 |g year:2021 |g number:3 |g day:04 |g month:06 |g pages:474-485 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1111/1475-6773.13629 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 56 |j 2021 |e 3 |b 04 |c 06 |h 474-485 | ||