Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
Ann Emerg Med. 2021 Jan;77(1):62-68. doi: 10.1016/j.annemergmed.2020.08.010. Epub 2020 Nov 5.
There has been increasing attention to screening for health-related social needs. However, little is known about the screening practices of emergency departments (EDs). Within New England, we seek to identify the prevalence of ED screening for health-related social needs, understand the factors associated with screening, and understand how screening patterns for health-related social needs differ from those for violence, substance use, and mental health needs.
We analyzed data from the 2018 National Emergency Department Inventory-New England survey, which was administered to all 194 New England EDs during 2019. We used descriptive statistics to compare ED characteristics by screening practices, and multivariable logistic regression models to identify factors associated with screening.
Among the 166 (86%) responding EDs, 64 (39%) reported screening for at least one health-related social need, 160 (96%) for violence (including intimate partner violence or other violent exposures), 148 (89%) for substance use disorder, and 159 (96%) for mental health needs. EDs reported a wide range of social work resources to address identified needs, with 155 (93%) reporting any social worker availability and 41 (27%) reporting continuous availability.
New England EDs are screening for health-related social needs at a markedly lower rate than for violence, substance use, and mental health needs. EDs have relatively limited resources available to address health-related social needs. We encourage research on the development of scalable solutions for identifying and addressing health-related social needs in the ED.
人们越来越关注健康相关社会需求的筛查。然而,对于急诊科(ED)的筛查实践知之甚少。在新英格兰地区,我们旨在确定 ED 筛查健康相关社会需求的普遍性,了解与筛查相关的因素,并了解健康相关社会需求的筛查模式与暴力、物质使用和心理健康需求的筛查模式有何不同。
我们分析了 2019 年在新英格兰地区的 194 家 ED 中进行的 2018 年国家急诊科库存-新英格兰调查的数据。我们使用描述性统计数据来比较筛查实践的 ED 特征,并使用多变量逻辑回归模型来确定与筛查相关的因素。
在 166 家(86%)做出回应的 ED 中,有 64 家(39%)报告筛查了至少一种健康相关社会需求,160 家(96%)筛查了暴力(包括亲密伴侣暴力或其他暴力暴露),148 家(89%)筛查了物质使用障碍,159 家(96%)筛查了心理健康需求。ED 报告了广泛的社会工作资源来解决已确定的需求,其中 155 家(93%)报告了任何社会工作者的可用性,41 家(27%)报告了连续可用性。
新英格兰 ED 筛查健康相关社会需求的比例明显低于筛查暴力、物质使用和心理健康需求的比例。ED 提供的解决健康相关社会需求的资源相对有限。我们鼓励开展研究,开发可扩展的解决方案,以在 ED 中识别和解决健康相关社会需求。