Highly vulnerable groups, classified as those with the complex social and medical problems, are one of the most affected segments of social and health inequality across the world. In their study, Malbon, Carey and Meltzer assert that, persons with intellectual disability, and older people, are the most vulnerable groups to the health and social inequality (2019). In addressing the needs of these vulnerable groups, the health practitioners should understand the social elements while utilizing the wide-ranging health description including the social, psychological and biological dimensions. According to Adler, Glymour and Fielding (2016), there is considerable indication that several of the conditions and processes forbid the vulnerable groups from achieving cultural, communal, economic as well as political inclusion. Such aspects are strongly linked to the social and health inequalities. As such, there is need for the promotion of political action and commitment while raising awareness in addressing the conditions that make people vulnerable to social and health disparities and in particular addressing the needs and expectations of the vulnerable groups.
“ Pay for Performance” (P4P)
“Pay for Performance” (P4P) is the payment model which attaches incentives to the provider performance. Though the system has led to improved processes, the health outcome is still an issue. P4P is widely seen as a double-edged sword as it can reward and penalize a facility. Although the aim of the system is to ensure improved healthcare outcomes for the patients, reduction of healthcare costs and improvement on the care’s quality (Mendelson et al., 2017). However, since its implementation, there has not been solid evidence to proof that the system has been effective. In order to make the system more effective, there is need for the introduction of an iterative approach. The healthcare leaders must emphasize for the introduction of strategies that can address the social determinants of health while introducing equity measures aimed at producing fair provider comparisons (Gondi, Soled & Jha, 2019). This will guarantee that there is creation of P4P programs that promote positive outcomes, quality and ensure that the patients are more satisfied while reducing the costs.
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References
Adler, N. E., Glymour, M. M., & Fielding, J. (2016). Addressing social determinants of health and health inequalities. Jama, 316(16), 1641-1642.
Gondi, S., Soled, D., & Jha, A. (2019). The problem with pay-for-performance schemes. BMJ quality & safety , 28(6), 511-513.
Malbon, E., Carey, G., & Meltzer, A. (2019). Personalization schemes in social care: are they growing social and health inequalities? BMC Public Health , 19(1), 805
Mendelson, A., Kondo, K., Damberg, C., Low, A., Motúapuaka, M., Freeman, M., & Kansagara, D. (2017). The effects of pay-for-performance programs on health, health care use, and processes of care: a systematic review. Annals of Internal Medicine , 166(5), 341-353.
