Implementing Health Related Social Needs Screening in an Outpatient Clinic.
| Autor: | Nohria, Raman, Xiao, Nan, Guardado, Rubeen, Drainoni, Mari-Lynn, Smith, Cara, Nokes, Keith, Byhoff, Elena |
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| Předmět: |
INSURANCE companies
SOCIAL determinants of health CONFIDENCE intervals CROSS-sectional method MEDICAL screening COMMUNITY health services HUMAN services programs MEDICAL care use PRIMARY health care DESCRIPTIVE statistics RESEARCH funding NEEDS assessment STATISTICAL sampling LOGISTIC regression analysis ODDS ratio DATA analysis software OUTPATIENT services in hospitals |
| Zdroj: | Journal of Primary Care & Community Health; 8/17/2022, Vol. 13, p1-9, 9p |
| Abstrakt: | Introduction/Objectives: Health-related social needs (HRSN) screening efforts have reported high rates of identified social needs. Little is known if efforts to conduct HRSN screening in resource-constrained federally-qualified health centers (FQHC) successfully captures a representative patient population. Methods: This cross-sectional study extracted EMR data from 2016 to 2020 for 4731 screened patients from 7 affiliated clinics of a FQHC. Unscreened patients were pulled as a random sample from the study period. A multivariable logistic regression was used to identify sociodemographic traits, chronic disease diagnoses and burden, and clinic visit type and frequency associated with being screened for HRSN. Results: BHC screened 4731 unique patients or <1% of the total clinic population. Screened patients had a median of 3.3 (±2.5) unmet HRSN. Medicaid patients had higher odds of being screened (aOR = 1.38, CI 1.19-1.61) relative to Medicare patients. The odds of being screened for social needs increased with more provider visits per year: compared to fewer than 1 visit per year, patients with 1 to 3 provider visits (aOR = 2.06, CI 1.73-2.32), 4 to 6 provider visits (aOR = 3.34, CI 2.89-3.87), and more than 6 provider visits (aOR = 5.16, CI 4.35-6.12) all had higher odds of social needs screening. Patients with a higher comorbid disease burden (>2 conditions, aOR = 2.80, CI 2.07-3.79) had higher odds of screening. Conclusions: Our findings demonstrate an increased likelihood to screen patients who visit outpatient services more often and have a higher comorbid disease burden. To meet state-level Medicaid requirements, resource-constrained FQHCs that implement clinic wide HRSN screening may be well served to identify a priori strategies to ensure representative and equitable screening across the patient population. [ABSTRACT FROM AUTHOR] |
| Databáze: | Complementary Index |
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