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医院伙伴关系促进人群健康:文献系统综述。

Hospital Partnerships for Population Health: A Systematic Review of the Literature.

机构信息

IU Richard M. Fairbanks School of Public Health, Indianapolis, Indiana.

IU Richard M. Fairbanks School of Public Health.

出版信息

J Healthc Manag. 2021;66(3):170-198. doi: 10.1097/JHM-D-20-00172.

Abstract

The U.S. healthcare system continues to experience high costs and suboptimal health outcomes that are largely influenced by social determinants of health. National policies such as the Affordable Care Act and value-based payment reforms incentivize healthcare systems to engage in strategies to improve population health. Healthcare systems are increasingly expanding or developing new partnerships with community-based organizations to support these efforts. We conducted a systematic review of peer-reviewed literature in the United States to identify examples of hospital-community partnerships; the main purposes or goals of partnerships; study designs used to assess partnerships; and potential outcomes (e.g., process- or health-related) associated with partnerships. Using robust keyword searches and a thorough reference review, we identified 37 articles published between January 2008 and December 2019 for inclusion. Most studies employed descriptive study designs (n = 21); health needs assessments were the most common partnership focus (n = 15); and community/social service (n = 21) and public health organizations (n = 15) were the most common partner types. Qualitative findings suggest hospital-community partnerships hold promise for breaking down silos, improving communication across sectors, and ensuring appropriate interventions for specific populations. Few studies in this review reported quantitative findings. In those that did, results were mixed, with the strongest support for improvements in measures of hospitalizations. This review provides an initial synthesis of hospital partnerships to address population health and presents valuable insights to hospital administrators, particularly those leading population health efforts.

摘要

美国的医疗保健系统持续面临高成本和不理想的健康结果,这些主要受到健康的社会决定因素的影响。《平价医疗法案》和基于价值的支付改革等国家政策激励医疗系统采取策略来改善人口健康。医疗系统越来越多地与社区组织扩大或开发新的伙伴关系,以支持这些努力。我们对美国同行评议文献进行了系统回顾,以确定医院-社区伙伴关系的例子;伙伴关系的主要目的或目标;用于评估伙伴关系的研究设计;以及与伙伴关系相关的潜在结果(例如,与过程或健康相关的结果)。使用强大的关键字搜索和彻底的参考文献审查,我们确定了 2008 年 1 月至 2019 年 12 月期间发表的 37 篇文章以供纳入。大多数研究采用描述性研究设计(n = 21);健康需求评估是最常见的伙伴关系重点(n = 15);社区/社会服务(n = 21)和公共卫生组织(n = 15)是最常见的伙伴类型。定性研究结果表明,医院-社区伙伴关系有希望打破隔阂,改善跨部门沟通,并确保为特定人群提供适当的干预措施。本综述中的少数研究报告了定量研究结果。在那些报告了定量结果的研究中,结果参差不齐,对改善住院治疗措施的支持最强。本综述提供了一个初步的医院伙伴关系综述,以解决人口健康问题,并为医院管理人员,特别是那些领导人口健康工作的人员提供了有价值的见解。

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