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Social Determinants of Health and healthcare equality is a big deal in my current position. I help with discharge coordination and often find myself struggling to get my patients the correct follow up and care necessary for these patients to be successful at home because of the area of town they live in. Banerjee states that for every patient who seeks healthcare, there are many that fail to make it to a healthcare facility (2020). Itâ€™s not realistic that healthcare will be easily available to everyone tomorrow, however facilities like the one mentioned by Schoonover took the initiative to find where the issues are and worked to create a solution (2018). They adjusted their education materials to be available in multiple languages, used analytics to monitor effectiveness of interventions on their less fortunate populations and provided at home screening tests. Having transportation, family support, financial access, distance and culturally diverse healthcare are all barriers to patients not seeking appropriate healthcare. This is unfortunate as these patientsare generally thevulnerable population requiring more care.
In the Critical Care Unit, not very many patients discharge directly from there so my example will come from a medical surgical patient on my professional unit. I had a homeless patient who had severe frostbite on his toes. Podiatry had seen him and told him not to put weight on his legs. This gentleman had no other option but to go to the homeless shelter which is located downtown in our capital city about 15 minutes away. The benefit of this homeless shelter is that there is a first come first served doctor’s office. With that being said, this patient also had to follow up with Podiatry which was located 15 minutes away. Keep in mind this gentleman has no transportation, no insurance, no money, no family and is unable to walk. The homeless shelter requires people to be out of the building during the day and requires them to be independent with activities. This gentleman was difficult for us to have a discharge plan where everyone felt comfortable with as there was no magical solution to all of his issues. Thankfully, my organization provides opportunities for social work and case managers to give bus passes and uber health rides to people in these situations to be able to get the appropriate follow up care and get to a safe discharge destination. Typically, the homeless population is very resistant to seeking healthcare as they often feel judged and labeled.
Homeless and the less fortunate population was found to have lower life expectancy rates and die because of chronic illnesses (Ramsey et al., 2019). My organization is implementing a program called social determinants of health, this link provides community resources for barriers identified. Although steps are being taken to decrease these negative outcomes, there is still a lot of effort needed to meet this populationâ€™s medical needs.
Banerjee. A., (2020). Equity and quality of health-care access: Where do we stand and the way forward? Indian Journal of Community Medicine, 45(1), 4â€“7. https://doi-org.ezp.waldenulibrary.org/10.4103/ijcm.IJCM_183_19
Ramsay, N., Hossain, R., Moore, M., Milo, M., & Brown, A. (2019). Health care while homeless: Barriers, facilitators, and the lived experiences of homeless individuals accessing health care in a Canadian regional municipality. Qualitative Health Research, 29(13), 1839â€“1849. https://doi-org.ezp.waldenulibrary.org/10.1177/1049732319829434