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住院医师对健康社会决定因素的记录:门诊环境中一种教学工具的效果

Resident Documentation of Social Determinants of Health: Effects of a Teaching Tool in the Outpatient Setting.

作者信息

Patel Milani, Bathory Eleanor, Scholnick Jenna, White-Davis Tanya, Choi Jaeun, Braganza Sandra

机构信息

1 Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.

出版信息

Clin Pediatr (Phila). 2018 Apr;57(4):451-456. doi: 10.1177/0009922817728697. Epub 2017 Sep 7.

DOI:10.1177/0009922817728697
PMID:28877598
Abstract

Social determinants of health (SDH) significantly affect the health of children and thus, screening is important in pediatric primary care. We assessed the use of a formal social history taking tool after a 2-phase intervention. The first phase (P1) was a teaching module describing SDH and community resources and the second phase (P2) consisted of visual reminders to use the tool. Patient charts (n = 322) were reviewed pre- and postintervention. Residents had higher documentation rates of Women, Infants, and Children (WIC) program use and housing subsidies at post-P1 and at post-P(1 + 2) (WIC, P = .01 and P = .03, respectively; housing, P = .02 and P = .04, respectively), and higher documentation rates of food stamp utilization at post-P(1 + 2) ( P = .04), as compared with baseline. Implementation of a simple teaching tool in the outpatient setting enabled residents to document income benefits and housing. Further studies should be done to evaluate effective teaching methods to elicit other important SDH.

摘要

健康的社会决定因素(SDH)对儿童健康有重大影响,因此,在儿科初级保健中进行筛查很重要。我们在两阶段干预后评估了一种正式社会病史采集工具的使用情况。第一阶段(P1)是一个描述SDH和社区资源的教学模块,第二阶段(P2)包括使用该工具的视觉提示。在干预前后对患者病历(n = 322)进行了审查。与基线相比,住院医师在P1后和P(1 + 2)后对妇女、婴儿和儿童(WIC)项目使用情况和住房补贴的记录率更高(WIC,分别为P = 0.01和P = 0.03;住房,分别为P = 0.02和P = 0.04),在P(1 + 2)后食品券使用的记录率更高(P = 0.04)。在门诊环境中实施一种简单的教学工具使住院医师能够记录收入福利和住房情况。应开展进一步研究以评估引出其他重要SDH的有效教学方法。

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