Commentary

Integrating social and behavioral determinants of health into patient care and population health at Veterans Health Administration: a conceptual framework and an assessment of available individual and population level data sources and evidence-based measurements

  • Received: 15 May 2019 Accepted: 24 June 2019 Published: 03 July 2019
  • The premise of this project was that social and behavioral determinants of health (SBDH) affect the use of healthcare services and outcomes for patients in an integrated healthcare system such as the Veterans Health Administration (VHA), and thus individual patient level socio-behavioral factors in addition to the neighborhood characteristics and geographically linked factors could add information beyond medical factors mostly considered in clinical decision making, patient care, and population health. To help VHA better address SBDH risk factors for the veterans it cares for within its primary care clinics, we proposed a conceptual and analytic framework, a set of evidence-based measures, and their data source. The framework and recommended SBDH metrics can provide a road map for other primary care-centric healthcare organizations wishing to use health analytic tools to better understand how SBDH affect health outcomes.

    Citation: Elham Hatef, Zachary Predmore, Elyse C. Lasser, Hadi Kharrazi, Karin Nelson, Idamay Curtis, Stephan Fihn, Jonathan P. Weiner. Integrating social and behavioral determinants of health into patient care and population health at Veterans Health Administration: a conceptual framework and an assessment of available individual and population level data sources and evidence-based measurements[J]. AIMS Public Health, 2019, 6(3): 209-224. doi: 10.3934/publichealth.2019.3.209

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  • The premise of this project was that social and behavioral determinants of health (SBDH) affect the use of healthcare services and outcomes for patients in an integrated healthcare system such as the Veterans Health Administration (VHA), and thus individual patient level socio-behavioral factors in addition to the neighborhood characteristics and geographically linked factors could add information beyond medical factors mostly considered in clinical decision making, patient care, and population health. To help VHA better address SBDH risk factors for the veterans it cares for within its primary care clinics, we proposed a conceptual and analytic framework, a set of evidence-based measures, and their data source. The framework and recommended SBDH metrics can provide a road map for other primary care-centric healthcare organizations wishing to use health analytic tools to better understand how SBDH affect health outcomes.


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    Acknowledgments



    We would like to thank our colleagues at the Department of Veterans Affairs Clinical Systems Development and Evaluation and Veterans Affairs Puget Sound Health Care System in Seattle, Washington for their support during this project.
    The Johns Hopkins University School of Public Health, Center for Population Health IT (CPHIT) performed this research under contract to the US Department of Veterans Affairs as a case study which included data assessments and stakeholder input as necessary.

    Conflict of interest



    Any recommendations put forth in this paper are the views of the authors and do not necessarily represent the views of the US Department of Veterans Affairs. Veterans Affairs (VA) had no disclosure of potential conflicts of interest.

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