Environmental Determinants

These are the Environmental Determinants that, if not addressed, may delay or prevent patient recovery. The top unmet basic needs that effect clinical outcomes are: housing, food, finances, transportation and literacy. (See: Improving Clinical Outcomes By Addressing Social And Basic Needs)

These are the Patient Environment Factors that are a component of the Patient Recovery Factors.

Socioeconomic Status

Socioeconomic status factors are elements of the Patient environment factors in patient recovery.

Financial Health

• Income
• Wealth
• Patient Contributions Capabilities
• Financial Constraints (Debt, family commitments) -

Job Status

• Sick Days/Leave Availability
• Occupation

Education

• Completed levels of formal education
• Literacy

Medical Insurance Status

• Employer plan, Medicare, Medicaid, VA, etc.)
• Deductibles, Co-payments, monthly premiums

Socioeconomic - History

• Credit Rating & History

Home

Home factors are elements of the Patient environment factors in patient recovery.

Home

• Environmental (Heat, Air conditioner, Mold-Asthma, Noise-levels)
• Safety - banisters, Throw rugs (recent hip replacements), home safety checklist
• Household members (disruptive/supportive family member)
• Accessibility (Wheel Chair accessible)
• Therapy Equipment (Oxygen equipment)
• Passive Sensors (wifi enabled weight scale, blue tooth enabled blood pressure cuff)
• Internet connection - wifi router
• Onsite Care Giver Support (i.e., family member)

Location

• Proximity to services, schools, grocery, etc.
• Neighborhood - supportive (neighbors friendly), side walks, parks
• Safety - for walks, security, quiet at night (able to get restful sleep)
• Transportation Access

Facility - Supportive

• Facility type (Nursing home, senior living center, etc.)
• Onsite staff (match needs of patients)
• Onsite resources (food, outdoors, etc.)
• Accessible (Wheel Chair ramps)
• Safety (Safety Bathrooms, smoke alarms)
• Environmental (Heat, A/C, Mould)
• Therapy Equipment (Oxygen equipment)
• Passive Sensors (wifi enabled weight scale, blue tooth enabled blood pressure cuff)
• Internet connection - wifi router

Temporary Housing

• Homelessness
• Homeless Shelters
• Family or Friends House
• Halfway House - after recent prison term
• Victim Shelters - domestic and sexual violence, disaster relief

Access & Logistics

Access & logistics factors are elements of the Patient environment factors in patient recovery.

Necessities Access

(via delivery or going to the store)

• Medicines
• Food (via delivery or going to the store)
• Other

Transportation

• Physician Offices
• Special Transportation Needs (Wheel Chair Vehicle)

Clinical Services Access

• Same day access to Physicians
• Nights & Weekend Access to providers
• Clinical Care in area, region (i.e., dialysis)