Truly Patient-Centered Clinical Pathways
For clinical pathways to be most effective, they need to accommodate many external factors impacting patients. These include issues such as the social determinants of health, as well as access to care that can impact health outcomes—especially for vulnerable Medicare patients. Taking into account these critical factors is essential for the development and execution of truly patient-centered clinical pathways.
Social Determinants of Health
The social determinants of health take into account when and where people are born, live, work, and how these attributes affect their health. The federal initiative Healthy People 2020 emphasizes the importance of social determinants of health, stating that social and physical determinants of health impact a wide range of health, functioning, and quality-of-life outcomes. Social and physical determinants of health are often the result of decisions made at the higher levels of society.1
The basis for inclusion of social determinants of health starts in our homes, schools, workplaces, neighborhoods, and communities. Health is also determined in part by access to social and economic opportunities; the resources and supports available in our homes, neighborhoods, and communities; the quality of our schooling; the safety of our workplaces; the cleanliness of our water, food, and air; and the nature of our social interactions and relationships.
Healthy People 2020 emphasizes the importance of addressing the social determinants of health by including “…social and physical environments that promote good health for all” as one of the four overarching goals for the decade. This emphasis is shared by the World Health Organization (as described in Table 1), and other United States–based health initiatives such as the National Partnership for Action to End Health Disparities and the National Prevention and Health Promotion Strategy.
The social determinants of health topic area within Healthy People 2020 is designed to identify ways to create social and physical environments that promote good health for all. These factors need to be taken into account when developing clinical pathways to achieve optimum health outcomes.