Jan 9, 2020

A care model for the sickest patients doesn't work

An emergency room is a common site for "superutilizers." Photo: Leonard Ortiz/Digital First Media/Orange County Register via Getty Images

Providing close follow-up care from a team of clinical and social workers to the sickest, most vulnerable patients does not reduce hospital readmissions, a new study in the New England Journal of Medicine concludes.

Why it matters: Many doctors and scholars viewed this approach as a promising way to improve care and save money, but it doesn't appear to do either.

What happened: Unexpected life changes or holes in social programs derailed the lives of many patients who were getting the extra help, forcing them to put their health needs on the back burner.

  • One patient who participated in the study told the Tradeoffs podcast that he lost contact with his social workers and providers because he was evicted and became homeless — leading to many repeat visits to his hospital. 

The bottom line: Giving extra health care support to patients who are struggling with poverty, addiction, hunger and other issues is still the right thing to do.

  • But that model doesn't cure the deeper problems within other parts of the country's social safety net, like housing.

Go deeper: There is an important difference between "social needs" and "social determinants of health," health economist Austin Frakt wrote last year.

Go deeper

George Floyd updates

Protesters in Washington, D.C. on June 6. Photo: Samuel Corum/Getty Images

Tens of thousands of demonstrators are rallying in cities across the U.S. and around the world to protest the killing of George Floyd. Huge crowds have assembled in Washington, D.C., Philadelphia and Chicago for full-day events.

Why it matters: Twelve days of nationwide protest in the U.S. has built pressure for states to make changes on what kind of force law enforcement can use on civilians and prompted officials to review police conduct. A memorial service was held for Floyd in Raeford, North Carolina, near where he was born. Gov. Roy Cooper ordered all flags to fly at half-staff to honor him until sunset.

Updated 3 hours ago - World

In photos: People around the world rally against racism

Despite a ban on large gatherings implemented in response to the coronavirus pandemic, protesters rally against racism in front of the American Embassy in Paris on June 6. Photo: Julien Mattia/Anadolu Agency via Getty Images

Tens of thousands of people have continued to rally in cities across the world against racism and show their support this week for U.S. demonstrators protesting the death in police custody of George Floyd.

Why it matters: The tense situation in the U.S. has brought the discussion of racism and discrimination onto the global stage at a time when most of the world is consumed by the novel coronavirus.

Updated 4 hours ago - Politics & Policy

Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Global: Total confirmed cases as of 7:30 p.m. ET: 6,852,810 — Total deaths: 398,211 — Total recoveries — 3,071,142Map.
  2. U.S.: Total confirmed cases as of 7:30 p.m. ET: 1,917,080 — Total deaths: 109,702 — Total recoveries: 500,849 — Total tested: 19,778,873Map.
  3. Public health: Why the pandemic is hitting minorities harder — Coronavirus curve rises in FloridaHow racism threatens the response to the pandemic Some people are drinking and inhaling cleaning products in attempt to fight the virus.
  4. Tech: The pandemic is accelerating next-generation disease diagnostics — Robotics looks to copy software-as-a-service model.
  5. Business: Budgets busted by coronavirus make it harder for cities to address inequality Sports, film production in California to resume June 12 after 3-month hiatus.
  6. Education: Students and teachers flunked remote learning.