Understanding the Role of a Technology and EMR-based Social Determinants of Health Screening Tool and Community-based Resource Connections in Health Care Resource Utilization.
Journal
Medical care
ISSN: 1537-1948
Titre abrégé: Med Care
Pays: United States
ID NLM: 0230027
Informations de publication
Date de publication:
01 07 2023
01 07 2023
Historique:
medline:
12
6
2023
pubmed:
3
2
2023
entrez:
2
2
2023
Statut:
ppublish
Résumé
Health systems are increasingly investing in social determinants of health (SDoH), but there is limited research on how such efforts impact health care resource use. This study presents pilot work on an SDoH screening and referral platform recently implemented in South Carolina's largest private nonprofit health system. To assess the feasibility and sustainability of SDoH screening and SDoH-related referrals in a large health system and examine how they affect health resource use. Observational study using electronic medical records and SDoH screening data from June 1, 2019 to December 31, 2020. Patients (18 y+) engaged in community health, inpatient case management, or ambulatory care and condition management programs. We describe the use of SDoH screening by providers (community health workers, nurse case managers, and social workers) and SDoH referral volumes among patients. We use multivariate analyses to predict changes in emergency department visits, inpatient admission s (length of stay and volume), and primary care visits from referral volume, SDoH screening question responses, and patient characteristics (eg, comorbidities). Of 2687 patients, 662 (24.6%) screened positive for 1 or more SDoH domains. SDoH screening performance remained consistent among providers over time. Six hundred fifty-eight (24.5%) patients received SDoH referrals. Patients receiving an increasing volume of referrals had decreasing primary care visits but their comorbidities moderated this effect. The study provides initial descriptive information on SDoH needs, implementation of referrals and resource use, guiding SDoH screening implementation in population health, and care management programs.
Sections du résumé
BACKGROUND
Health systems are increasingly investing in social determinants of health (SDoH), but there is limited research on how such efforts impact health care resource use. This study presents pilot work on an SDoH screening and referral platform recently implemented in South Carolina's largest private nonprofit health system.
OBJECTIVES
To assess the feasibility and sustainability of SDoH screening and SDoH-related referrals in a large health system and examine how they affect health resource use.
RESEARCH DESIGN
Observational study using electronic medical records and SDoH screening data from June 1, 2019 to December 31, 2020.
SUBJECTS
Patients (18 y+) engaged in community health, inpatient case management, or ambulatory care and condition management programs.
MEASURES
We describe the use of SDoH screening by providers (community health workers, nurse case managers, and social workers) and SDoH referral volumes among patients. We use multivariate analyses to predict changes in emergency department visits, inpatient admission s (length of stay and volume), and primary care visits from referral volume, SDoH screening question responses, and patient characteristics (eg, comorbidities).
RESULTS
Of 2687 patients, 662 (24.6%) screened positive for 1 or more SDoH domains. SDoH screening performance remained consistent among providers over time. Six hundred fifty-eight (24.5%) patients received SDoH referrals. Patients receiving an increasing volume of referrals had decreasing primary care visits but their comorbidities moderated this effect.
CONCLUSIONS
The study provides initial descriptive information on SDoH needs, implementation of referrals and resource use, guiding SDoH screening implementation in population health, and care management programs.
Identifiants
pubmed: 36729786
doi: 10.1097/MLR.0000000000001800
pii: 00005650-202307000-00003
doi:
Types de publication
Observational Study
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
423-430Informations de copyright
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
The authors declare no conflicts of interest.
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