Date: Tuesday, February 18, 2025
Hi, I’m Sonja Hoover, a senior director and health services researcher at Implenomics. I have experience working on projects related to the intersection of implementation science and economics with a focus on health equity.
Implenomics has developed the Health Equity and Economics Assessment Linkages (HEEAL) framework (shown below) that provides an equity lens to guide data collection and support economic analysis that will allow for data-driven decision making on strategies and policies to address health disparities.
We used an iterative and consultive approach to creating HEEAL. The process included:
The first row shows the cancer continuum of care, which ranges from prevention through survivorship and end-of-life care. At each point on the continuum there can be health care failures, such as not having a usual source of care or not having a usual source of care who recommends screening. These failures can lead to health care disparities for people with a diagnosis of cancer, such as late-stage diagnosis. The framework then shows how disparities and barriers affect health outcomes.
The final component describes the relationship between economic drivers and economic impacts. Economic drivers can include insurance and employment status, which has an impact on direct medical, direct non-medical and indirect costs. We show the dynamic between the two as cyclical.
We’ve found the framework to be robust, as we are using it in two of our current studies: a survey on social determinants of health driven barriers related to screening, diagnosis, and treatment as well as a microsimulation model.
To develop a framework, collaborate with a diverse group of experts. Then, pilot test the framework through multiple scenarios using real world examples.
Conceptual frameworks are important to generate data-informed policies and strategies to address health disparities.
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