Hospitals are logical hubs for tackling community socioeconomic issues that affect population health, but several challenges stand in the way, according to a new discussion paper from the Brookings Institute.
The paper is based on experiences at Washington Adventist Hospital, a community hospital in the District of Columbia's Maryland suburbs. The hospital, part of the Adventist HealthCare system, emphasizes community care and "has aggressively undertaken a range of community initiatives" to address so-called upstream factors influencing community health, according to the executive summary.
Those initiatives include working with an organization that helps connect discharged patients with social services, benefits and faith-based nurses programs; a strategy to tackle safety and other issues in high-crime housing projects; and a proposal with the county for the provision of transitional housing for homeless patients.
Challenges uncovered while researching Adventist's experiences included:
Because a hospital's impact on a community is rarely measured or rewarded, there are "insufficient incentives for hospitals to realize their full potential."
The regulatory and budget flexibility required to promote creative approaches to upstream community issues is rarely available, especially at the state and county level.
Data interoperability and privacy laws hamper the data sharing required for creating effective partnerships.
The paper is part of a Brookings series on building healthy neighborhoods.
Already hospitals are collaborating with one another, often on a regional level, to partner with community organizations and assess community health needs, FierceHealthcare previously reported. But, four out of five queried for a study said they didn't have the financial resources to address population health. Fewer than 1 in 5 said their hospital had programs to address socioeconomic health issues.
Unemployment and lack of a high school education are the most statistically significant socioeconomic factors in 30-day readmissions for heart failure, heart attacks and pneumonia, research has shown.