Healthcare Safety Net during Pandemic

The COVID-19 pandemic has been expected to lead to substantial increases in need for behavioural healthcare . A population  health framework can facilitate the development of interventions and policies to promote the equitable distribution of care across the population . COVID-19 has been expected to have severe consequences for behavioural health worldwide .A population health approach provides a framework for addressing the anticipated increase  in service need and barriers to accessing care .Population health refers to health outcomes distributed across a group of individuals ,the determinants of these outcomes, and interventions, and the policies that influence these determinants and outcomes .COVID-19 and concurrent national reckoning on racial and social injustice have presented challenges and opportunities for health system to provide effective and equitable healthcare .  

         References - //ps.psychiatryonline.org/doi/10.1176/appi.ps.20200054

The Institute of Medicine defines safety net practices as “those providers that organize and deliver a significant level of health care and other needed services to uninsured, Medicaid and other vulnerable patients” (1). This study analyses the concept of healthcare safety net during the COVID-19 pandemic based on the double diamond model and identifies its characteristics to better understand the health care safety net (2).

References

1. //www.ahrq.gov/ncepcr/tools/pf-handbook/mod2.html
2. //www.ncbi.nlm.nih.gov/pmc/articles/PMC8393212/

Healthcare safety net is a legally mandatory service provided to uninsured and groups with low social security insurance coverage. It is to provide first line emergency care for vulnerable population. Many healthcare systems accelerated their working capacity to meet the demands of the affected people during pandemic while many health care safety nets lacked infrastructure and EHR capacity due to a lot of contemplations among the governments to invest more on safety nets. Apart from this digital access to safety net among patient population also existed.

While Public health care extends its medical services beyond religion, caste and creed, health care safety net focuses during pandemic on vulnerable groups. People deprived of socio-economic status felt that they were socially isolated because of their low financial resources.

1. During the pandemic Korean hospitals moved forward to establish health care safety nets to extend a wide coverage of screening facilities. Tele medicine and video conferencing were enabled by safety nets.
2. In United States confirmed cases of COVID-19 were highest in the world. Most families belonging to racial/ethnic minorities were not in a position to pay their bills, access food and find new jobs. The national survey reported the enrolment of these  people with health care safety net programs for their survival.

While safety net programs are a critical component of health care access, they are not a substitute for the protection often afforded by comprehensive health insurance.

Citation

1. Saloner B, Gollust SE, Planalp C, Blewett LA. Access and enrollment in safety net programs in the wake of COVID-19: A national cross-sectional survey. PLoS One. 2020 Oct 6;15(10):e0240080. doi: 10.1371/journal.pone.0240080. PMID: 33022013; PMCID: PMC7537892.

2. Park BM, Lee HJ. Healthcare Safety Nets during the COVID-19 Pandemic Based on Double Diamond Model: A Concept Analysis. Healthcare (Basel). 2021 Aug 7;9(8):1014. doi: 10.3390/healthcare9081014. PMID: 34442151; PMCID: PMC8393212.

3. Sadasivaiah S, Shaffer E, Enanoria W, Su G, Goldman S, Scarafia J, Lee T, Yu A, Goldman LE, Ratanawongsa N. Informatics response to address the COVID-19 pandemic in a safety net healthcare system. JAMIA Open. 2021 Feb 22;4(3):ooaa057. doi: 10.1093/jamiaopen/ooaa057. PMID: 34504999; PMCID: PMC7928896.

The coronavirus pandemic has exposed gaps not only in the healthcare system of countries but also their social safety net. The health insurance programs that are supposed to bridge the need of funds for unexpected health emergencies and health care services do not cover the vulnerable patients. They do not have access to important health care services, and coverage under various hospitals and healthcare organizations even when the care providing charges can be reimbursed. The healthcare safety is an essential component to prevent the vulnerable population health as well. This can be done by improving prompt testing and treatment of patients with COVID-19, building capacity of hospitals and health care practitioners, and providing facilities changes by limiting transmission of COVID-19 in how care is delivered. Also, expanding options for Telehealth and Virtual sessions, remove barriers for affordability for diagnostic and treatment service, expanding coverage of Home-Based care and easing limits on prescription drugs and rehabilitation services and support.

References:

1. //jamanetwork.com/journals/jama/fullarticle/2763487
2. //www.urban.org/events/how-might-states-responses-pandemic-affect-safety-net-programs