Fichtenberg Caroline, Delva Jorge, Minyard Karen, Gottlieb Laura M
Caroline Fichtenberg ( Caroline. Fichtenberg@ucsf. edu ) is managing director of the Social Interventions Research and Evaluation Network and a research scientist in the Department of Family and Community Medicine at the University of California San Francisco.
Jorge Delva is dean of the School of Social Work, director of the Center for Innovation in Social Work and Health, and the Paul Farmer Professor, all at Boston University, in Massachusetts.
Health Aff (Millwood). 2020 Apr;39(4):567-573. doi: 10.1377/hlthaff.2019.01594.
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. In doing so, particular attention needs to be paid to understanding how power and resource differentials between organizations in the two sectors influence integration approaches and their impacts. Furthermore, increased societal investments in resources to address social needs are likely necessary for integrative initiatives to yield desired individual- and population-level impacts.
关于健康的社会决定因素的证据不断增加,以及基于价值的医疗保健激励措施的使用,正在推动整合医疗保健和人类服务的新努力。尽管人们期望这些互补服务的整合能够改善健康状况、减少健康不平等,并减少潜在的可避免的医疗保健使用和成本,但目前关于这种跨部门伙伴关系的有效性、实施情况和可持续性的证据却很少且参差不齐。为了实现医疗保健和人类服务整合的潜力,必须填补这些关键领域的知识空白。在这样做的过程中,需要特别注意了解两个部门组织之间的权力和资源差异如何影响整合方法及其影响。此外,社会可能需要增加对解决社会需求资源的投资,以使整合举措产生预期的个人和人群层面的影响。