The time is now: Addressing health inequities in the workforce.

IF 2.3 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Bruce W Sherman, Brian Sils, Kimberly Westrich
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Abstract

As a major provider of health insurance for working-age Americans, employers can play a significant role in improving the health equity of their employees and family members. In this commentary, we describe how different stakeholders, including employers, their employees, clinicians, and health systems and health plans, each contribute to the observed inequities. Other systems-level factors, including racism, implicit bias, medical mistrust, health literacy limitations, and health care access and affordability concerns have been also shown to contribute to inequitable outcomes. Opportunities exist for employers to improve health equity among their benefits-enrolled employees and family members using data-driven approaches to ensure that benefits are more equitable in scope, access, and affordability. As an illustrative example of employer strategic considerations, we describe opportunities to identify and address inequities in prescription medication use. Additionally, employers can, and perhaps should, advocate for transparency in community-based health system and health plan reporting regarding health inequities and progress toward more equitable health care utilization and outcomes. Employers can also advocate for the delivery of more patient-centered, systems-based solutions, such as enhanced primary care and/or worksite clinics, and give consideration to establishing health equity performance-based incentives in their health care contracting. Further research in the employer setting can help to expand the adoption of a best-practices approach to achieving more equitable health outcomes.

现在是时候了:解决劳动力中的卫生不平等问题。
作为工作年龄美国人健康保险的主要提供者,雇主可以在改善其雇员及其家庭成员的健康公平方面发挥重要作用。在这篇评论中,我们描述了不同的利益相关者,包括雇主、雇员、临床医生、卫生系统和卫生计划,每个人如何促成观察到的不公平现象。其他系统层面的因素,包括种族主义、隐性偏见、医疗不信任、卫生素养限制以及卫生保健获取和负担能力问题,也被证明会导致不公平的结果。雇主有机会利用数据驱动的方法,改善参加福利的雇员和家庭成员之间的健康公平,以确保福利在范围、可及性和可负担性方面更加公平。作为雇主战略考虑的一个说明性例子,我们描述了识别和解决处方药使用不公平的机会。此外,雇主可以(也许应该)倡导社区卫生系统和卫生计划报告中关于卫生不公平的透明度,以及朝着更公平的卫生保健利用和结果取得进展。雇主还可以提倡提供更多以患者为中心、以系统为基础的解决方案,例如加强初级保健和/或现场诊所,并考虑在医疗保健合同中建立基于绩效的卫生公平激励机制。在雇主环境下进行进一步研究,有助于扩大采用最佳做法,以实现更公平的健康结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of managed care & specialty pharmacy
Journal of managed care & specialty pharmacy Health Professions-Pharmacy
CiteScore
3.50
自引率
4.80%
发文量
131
期刊介绍: JMCP welcomes research studies conducted outside of the United States that are relevant to our readership. Our audience is primarily concerned with designing policies of formulary coverage, health benefit design, and pharmaceutical programs that are based on evidence from large populations of people. Studies of pharmacist interventions conducted outside the United States that have already been extensively studied within the United States and studies of small sample sizes in non-managed care environments outside of the United States (e.g., hospitals or community pharmacies) are generally of low interest to our readership. However, studies of health outcomes and costs assessed in large populations that provide evidence for formulary coverage, health benefit design, and pharmaceutical programs are of high interest to JMCP’s readership.
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