Communities of poor, low-income immigrants with limited English proficiency and disproportionate health burdens pose unique challenges to health providers and policy-makers.
NewYork-Presbyterian Hospital developed the Regional Health Collaborative, a population-based health care model to improve the health of the residents of Washington Heights–Inwood. This area is a predominantly Hispanic community in New York City with high rates of asthma, diabetes, heart disease, and depression. NewYork-Presbyterian created an integrated network of patient-centered medical homes to form a “medical village” linked to other providers and community-based resources. The initiative set out to document the priority health needs of the community, target high prevalence conditions, improve cultural competence among providers, and introduce integrated information systems across care sites.
The first six months of the program demonstrated a significant 9.2 percent decline in emergency department visits for ambulatory care–sensitive conditions and a 5.8 percent decrease in hospitalizations that was not statistically significant. This initiative offers a model for other urban academic medical centers to better serve populations facing social and cultural barriers to care.