Health Equity in Hospital Medicine
Foundations, Populations, and Action
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Beschreibung
This timely and thought-provoking book addresses the full range of health equity issues that impact the practice of hospital medicine, offering a fresh and comprehensive examination of the topic. Drawing from vast clinical experience, as well as from the latest evidence-based literature, the well-published hospitalist author encourages readers to reevaluate established practices and embrace that equitable hospital care must be applied with a systematic framework to ensure that social factors are deeply incorporated into the care provided -- so that it is truly equitable. Indeed, health equity is defined by the World Health Organization as “the absence of avoidable, unfair, or remediable differences among groups of people, whether those groups are defined socially, economically, demographically, or geographically, or by other means of stratification.” Health equity has not traditionally been incorporated into inpatient care in an intentional manner, says the author;yet, it is impossible to take care of patients who are acutely ill without taking into consideration the social milieu to which they will return. In fact, although hospital-based physicians are privy to some of the most meaningful moments of people’s lives, including life-changing diagnoses, pivotal medical procedures, complex medical decisions, and critical end-of-life decisions, they still have no framework for how to incorporate into clinical decision-making the varied social factors that impact care such as race, gender identity, cultural background, immigration status, sexual orientation, primary language, housing status, and poverty. The goal, emphasizes the author, should be to provide culturally humble healthcare that not only goes beyond speaking in the patient’s primary language but that also includes active listening and truly takes into consideration the life experiences and culture that have made patients who they are. Organized in three parts, thebook covers 1) the foundations of health equity 2) specific populations and various issues and 3) a framework and action plan for moving hospital medicine closer to offering consistent, systematic, equitable care. Health Equity in Hospital Medicine: Foundations, Populations, and Action is a call to action and an invaluable addition to the clinical literature. The title will be of great interest to hospital medicine physicians, to allied health personnel working in a hospital setting, and to trainees.
Hospital-based physicians are privy to some of the most meaningful moments of people’s lives, including life-changing diagnoses, pivotal medical procedures, complex medical decisions, and critical end-of-life decisions. Yet, hospitalists have no framework for how to incorporate the varied social factors that impact care such as race, gender identity, cultural background, immigration status, sexual orientation, primary language, housing status, and poverty into clinical decision-making. As hospital physicians, we may use interpreters for our limited English proficiency patients, or try to incorporate questions about cultural practices into our admission histories, or even ask our patients about the ways in which they feel racism has affected their care, but these practices are inconsistently applied and lack a systematic framework for ensuring that the hospital care we provide is truly equitable.
In my own practice as a hospital-based physician, I can recall scoresof hospitalized patients where we tried hard to provide equitable care, but fell short. I remember the Spanish-speaking patient with multiple comorbidities who received neurosurgery and was on the road to recovery on an acute care unit, when on day three, he complained of vague abdominal discomfort and ended up dying of a perforated bowel. No interpreter was used by the team to fully delve into the details of the pain he was experiencing. I remember the young Black patient with terminal malignancy who had multiple repeated conversations with physicians recommending hospice care but refused until he saw a physician who was able to explain hospice within the context of racism that has historically defined clinical care for Black people, and was able to present hospice not as a way to hasten death but rather as a way to live the remainder of his days in comfort. I remember the elderly Pakistani female patient whose demanding son antagonized staff and clinicians alike until he was banned from visiting because of his aggressiveness with staff and whose inability to visit his mother caused her extreme distress as she felt that she had lost the unique voice that only her oldest son could provide.Imagine if the hospital physicians in these cases had a resource to help them provide care that is culturally humble, that goes beyond just speaking in the patient’s first language but that also includes active listening and truly takes into consideration the life experiences and culture that have made this patient who they are. This is what this book will provide for hospital medicine physicians, a framework to help hospital physicians deeply incorporate social factors into the care they provide.
Comprehensive in addressing the full range of social determinants that impact healthcare Offers a balanced framework for hospital medicine physicians Written by an expert in the field
Autor*in
Sujatha Sankaran
Themen in »Health Equity in Hospital Medicine«
Clinical Medicine Internal medicine Practice and Hospital Management Cardiology Endocrinology