J Health Care Poor Underserved. 2020;31(1):382-397. doi: 10.1353/hpu.2020.0029.
Free and charitable clinics care for patients at risk of unmet social needs, but limited research is available describing what these clinics do to address social determinants of health (SDH). We conducted a survey of free and charitable clinics in North Carolina to determine the proportion that screen for SDH. Clinics that were members of the North Carolina Association of Free and Charitable Clinics were eligible (n=67). Of the 55 clinics that completed the survey, 34 (61.8%) reported always screening for at least one SDH. The majority that were screening provided information about community resources. Twentyseven (49.1%) reported that they followed-up with patients at the next visit to determine if they received the resources. The primary barrier to screening was a lack of personnel. Future research should focus on how to implement SDH interventions in clinics with limited resources serving patients likely to have a high need for social services.
免费和慈善诊所为有社会需求未得到满足风险的患者提供服务，但有关这些诊所如何解决健康的社会决定因素（SDH）的研究有限。我们对北卡罗来纳州的免费和慈善诊所进行了调查，以确定筛查 SDH 的比例。符合条件的是北卡罗来纳州免费和慈善诊所协会的成员（n=67）。在完成调查的 55 家诊所中，有 34 家（61.8%）报告说他们始终会筛查至少一种 SDH。大多数进行筛查的诊所会提供有关社区资源的信息。有 27 家（49.1%）报告说，他们会在下次就诊时与患者跟进，以确定他们是否获得了资源。筛查的主要障碍是人员不足。未来的研究应侧重于如何在资源有限的诊所中实施 SDH 干预措施，这些诊所服务的患者可能非常需要社会服务。
