The Impact of Place on Health: Built Environment and Healthcare Process Outcomes

Abstract

In recent years, healthcare reform has emphasized conformance quality improvements, notably in programs such as the Hospital Readmissions Reduction Program; however, programs meant to emphasize these improvements in health outcomes often disadvantage hospitals serving lower income communities. Contextual factors such as the neighborhoods that patients are drawn from can positively or adversely impact the outcome of treatment. This study seeks to understand the contextual factors surrounding patients to understand how the built environment factors surrounding patients impacts outcomes. We use the setting of the Hospital Readmissions Reduction Program to understand how built environment impacts conformance quality for relevant treatments. The findings indicate that built environment factors may impact a patient’s likelihood of being readmitted. This provides a possible context to explain the discrepancy between process improvement and current health outcomes.