Donald Wesson is president of the Baylor Scott & White Health and Wellness Center, in Dallas, Texas.
Heather Kitzman (
Health Aff (Millwood). 2018 Apr;37(4):543-550. doi: 10.1377/hlthaff.2017.1099.
Population health strategies that improve access to health care and address social determinants of health may reduce the use of costly emergency services. Here we describe a strategy adopted by Baylor Scott & White Health to reduce rising rates of emergency department use and inpatient hospitalizations in an underserved Dallas community that is home to many people with low socioeconomic status. Baylor Scott & White partnered with the Dallas Park and Recreation Department to create a level-three primary care clinic integrating wellness and prevention programs in a city recreational center. The clinic, known as the Baylor Scott & White Health and Wellness Center, exemplifies the integration of social determinants of health within a population health strategy. Emergency department (ED) and inpatient care use was examined over twelve months after initiation of services at the center. People who used the center's services showed a reduction in ED use of 21.4 percent and a reduction in inpatient care use of 36.7 percent, with an average cost decrease of 34.5 percent and 54.4 percent, respectively. These data support the use of population health strategies to reduce the use of emergency services.
改善医疗保健可及性和解决健康社会决定因素的人口健康策略可能会减少对昂贵的急诊服务的使用。在这里,我们描述了贝勒斯科特和怀特健康公司为减少达拉斯一个服务不足社区的急诊部门使用和住院率上升而采取的策略,该社区居住着许多社会经济地位较低的人。贝勒斯科特和怀特与达拉斯公园和娱乐部合作,在一个城市娱乐中心创建了一个三级初级保健诊所,将健康和预防计划整合在一起。该诊所被称为贝勒斯科特和怀特健康和健康中心,体现了人口健康战略中健康社会决定因素的整合。在该中心启动服务后的十二个月内,对急诊部和住院护理的使用情况进行了检查。使用该中心服务的人急诊使用率降低了 21.4%,住院护理使用率降低了 36.7%,平均成本分别降低了 34.5%和 54.4%。这些数据支持使用人口健康策略来减少急诊服务的使用。