密歇根健康中心的健康社会决定因素筛查
Screening for Social Determinants of Health in Michigan Health Centers.
作者信息
Byhoff Elena, Cohen Alicia J, Hamati Mary C, Tatko Julie, Davis Matthew M, Tipirneni Renuka
机构信息
From the Department of Medicine, Tufts University School of Medicine, and the Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA (EB); the Department of Family Medicine (AJC), the Institute for Healthcare Policy & Innovation (AJC, RT), and the Division of General Medicine (RT), University of Michigan, Ann Arbor; the Center for Clinical Management Research, Department of Veterans Affairs, Ann Arbor, MI (AJC); the Michigan State University College of Human Medicine, East Lansing (MCH); the Michigan Primary Care Association, Lansing (JT); the Departments of Pediatrics and Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL (MMD); the Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL (MMD).
出版信息
J Am Board Fam Med. 2017 Jul-Aug;30(4):418-427. doi: 10.3122/jabfm.2017.04.170079.
OBJECTIVE
Through an academic-community partnership with a statewide consortium of health centers (HCs) in Michigan, we characterize the current scope of screening for social determinants of health (SDH).
METHODS
We requested copies of forms used to screen for SDH at the 39 HC organizations in Michigan. Using content analysis, we examined variation in screening domains and processes. We present descriptive analyses of HC characteristics and patient demographics.
RESULTS
We received screening documentation from 23 of the 39 HCs (59%), representing 167 delivery sites. We found broad empiric consensus regarding a core set of 13 SDH screening domains that align with nationally recommended screening guidelines. Two additional domains, Culture and Functional Status, were screened for by <40% of HCs. While patient self-report is the most frequent mode of SDH screening (41%), many HCs use staff members to administer the screening documents.
CONCLUSIONS
HCs across a large and diverse state are screening for SDH and largely agree on core SDH screening domains. Using existing empiric data from frontline providers can inform potential best practices in SDH screening.
目的
通过与密歇根州全州范围内的健康中心（HCs）联盟建立学术-社区伙伴关系，我们描述了当前健康社会决定因素（SDH）筛查的范围。
方法
我们索取了密歇根州39个HC组织用于筛查SDH的表格副本。通过内容分析，我们研究了筛查领域和流程的差异。我们对HC特征和患者人口统计学进行了描述性分析。
结果
我们收到了39个HC中的23个（59%）的筛查文件，代表167个服务点。我们发现，对于与国家推荐的筛查指南一致的13个核心SDH筛查领域，存在广泛的经验共识。另外两个领域，即文化和功能状态，只有不到40%的HC进行筛查。虽然患者自我报告是最常见的SDH筛查方式（41%），但许多HC使用工作人员来管理筛查文件。
结论
一个地域广阔且多样化的州内的HC正在对SDH进行筛查，并且在核心SDH筛查领域上基本达成一致。利用一线提供者现有的经验数据可以为SDH筛查中的潜在最佳实践提供参考。
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