Gottlieb Laura, Colvin Jeffrey D, Fleegler Eric, Hessler Danielle, Garg Arvin, Adler Nancy
Department of Family and Community Medicine, University of California, San Francisco, 3333 California Street, Suite 465, San Francisco, CA, 94118, USA.
University of Missouri-Kansas City and Children's Mercy Hospital, Kansas City, MO, USA.
J Gen Intern Med. 2017 Mar;32(3):345-349. doi: 10.1007/s11606-016-3920-y. Epub 2016 Nov 14.
Despite substantial evidence documenting the social patterning of disease, relatively little information is available on how the health care system can best intervene on social determinants to impact individual and population health. Announced in January 2016, the Centers for Medicare and Medicaid Innovation's (CMMI) Accountable Health Communities (AHC) initiative provides an important opportunity to improve the evidence base around integrated social and medical care delivery. To maximize learning from this large-scale demonstration, comprehensive evaluation efforts should focus on effectiveness and implementation research by supporting local, regional, and national studies across a range of outcomes. Findings from this demonstration could transform how, when, and which patients' health-related social needs are addressed within the health care delivery system. Such findings would strongly complement other initiatives to address social factors outside of health care.
尽管有大量证据证明疾病存在社会模式，但关于医疗保健系统如何才能最好地干预社会决定因素以影响个人和人群健康的信息却相对较少。医疗保险和医疗补助服务中心创新中心（CMMI）于2016年1月宣布的 accountable Health Communities（AHC）计划提供了一个重要机会，可改善围绕综合社会和医疗服务提供的证据基础。为了从这一大规模示范中最大限度地获取经验，全面的评估工作应通过支持针对一系列结果的地方、区域和国家研究，专注于有效性和实施研究。这次示范的结果可能会改变在医疗保健服务系统中如何、何时以及为哪些患者解决与健康相关的社会需求。这些结果将有力地补充其他解决医疗保健之外社会因素的举措。
