Ending Health Disparities: Health, Environmental, and Social Justice in the Caribbean and Beyond

Panel discussion on Health and Social Justicefrom the Hospital PerspectiveChristine deJongh-Lewis, MPH, DHA Candidate

Associate Administrator of Operations

Schneider Regional Medical Center

cdlewis@srmedicalcenter.org

Schneider Regional Medical CenterSafety net provider

St. Thomas – St. John DistrictTerritorial Health System

Three facilities:◦Roy Lester Schneider Hospital◦Charlotte Kimelman Cancer Institute◦Myrah Keating Smith Community

Health Center

Focus of CareMission – To provide

comprehensive, quality healthcare to the residents and visitors of the VI in order to improve health and wellness.

Vision – To be the health care provider of choice to the residents of the VI and the Caribbean.

SOCIAL JUSTICE

HEALTH DISPARITIES

Social Justice, Health Disparities & SRMC

We care for all, regardless of ability to pay◦Critically ill patients◦Chronically ill patients◦Maternal / child health care patients

We train care providers◦Nursing students◦Clinical & experiential learning◦Brain drain considerations

Self Pay Patient Service Volume

Self Pay Patient Status 2009 2010 2011 2012Totals

Clinical Patients 30 14 12 18 74Emergency Room Patients 6049 6258 6522 6219 25048

Inpatients 1600 1422 1376 1338 5736Observation Patients 257 252 229 190 928Recurring Patients 400 390 412 375 1577

Referred Patients 1581 1492 1144 851 5068Surgical Day Care Patients 190 157 141 122 610

Totals 10107 9985 9836 9113 39041

Self Pay Reimbursement

Reimbursement 2009 2010 2011 2012Totals

Clinical Patients $ 2,940.37

$ 6,935.13

$ 4,135.80

$ 10,966.34

$ 24,977.64

Emergency Room Patients $ 2,564,688.55

$ 4,042,705.45

$ 4,863,361.99

$ 5,450,456.78

$ 16,921,212.77

Inpatients $ 7,958,008.68

$ 7,234,502.66

$ 7,727,408.02

$ 9,277,448.36

$ 32,197,367.72

Observation Patients $ 99,776.37

$ 192,086.83

$ 241,901.28

$ 304,177.47

$ 837,941.95

Recurring Patients $ 793,007.53

$ 626,529.93

$ 1,145,233.22

$ 1,336,920.28

$ 3,901,690.96

Referred Patients $ 212,067.61

$ 270,938.12

$ 278,669.41

$ 218,151.13

$ 979,826.27

Surgical Day Care Patients $ 576,893.80

$ 816,768.96

$ 625,071.44

$ 530,529.89

$ 2,549,264.09

Totals $ 12,207,382.91

$ 13,190,467.08

$ 14,885,781.16

$ 17,128,650.25

$ 57,412,281.40

Self Pay Charges

Charges 2009 2010 2011 2012Totals

Clinical Patients $ 4,753.05

$ 10,388.35

$ 4,406.45

$ 12,413.00

$ 31,960.85

Emergency Room Patients

$ 4,346,834.65

$ 4,789,383.02

$ 5,640,090.99

$ 6,182,960.43

$ 20,959,269.09

Inpatients $ 14,621,241.51

$ 14,341,815.99

$ 14,620,372.94

$ 16,665,993.40

$ 60,249,423.84

Observation Patients $ 184,323.66

$ 260,359.79

$ 285,977.66

$ 346,762.15

$ 1,077,423.26

Recurring Patients $ 1,682,749.39

$ 848,135.19

$ 1,539,448.91

$ 1,605,487.01

$ 5,675,820.50

Referred Patients $ 366,601.07

$ 374,159.24

$ 356,078.02

$ 260,983.09

$ 1,357,821.42

Surgical Day Care Patients

$ 1,021,314.66

$ 970,454.54

$ 923,343.34

$ 877,551.02

$ 3,792,663.56

Totals $ 22,227,817.99

$ 21,594,696.12

$ 23,369,718.31

$ 25,952,150.10

$ 93,144,382.52

Issues Impacting Social Justice in VI Healthcare

Budget reductionsReimbursement reductionsIncreased fixed costsIncreased staffing costs

◦Impact in scope of services◦Impact to care and treatment◦Social inequity in healthcare

Stakeholder Support◦Organizational opportunities exist◦Financial support required◦Collaboration required◦Innovative solutions required

Commitment to EquityBoardLeadershipFront line staff

◦Committed to the continued provision of care and treatment to all

◦Committed to improvement

Panel Discussion