2348 Harvard Affiliated Emergency Medicine Residency Program, Massachusetts General Hospital and Brigham and Women's Hospital, Boston, MA, USA.
Center for Social Justice and Health Equity, Massachusetts General Hospital, Boston, MA, USA.
Public Health Rep. 2021 May;136(3):309-314. doi: 10.1177/0033354920982579. Epub 2021 Feb 16.
Health-related social needs (HRSNs), such as food or housing insecurity, are important drivers of disparities in outcomes during public health emergencies. We describe the development of a telehealth follow-up program in Boston, Massachusetts, for patients discharged from the emergency department after coronavirus disease 2019 (COVID-19) testing to identify patients with worsening clinical symptoms, to screen for unmet HRSNs, and to deliver self-isolation counseling and risk-reduction strategies for socially vulnerable people. We prioritized telephone calls to patients with public health insurance and patients without primary care physicians. In the first 43 days of operation, March 30-May 12, 2020, our intervention reached 509 patients, with 209 (41.1%) patients reporting an HRSN, most commonly related to food, housing, or utilities. Thirty-one (6.1%) patients required assessment by a clinician for clinical worsening. This public health intervention may be useful for other institutions developing programs to address the social and health needs of patients discharged with suspected COVID-19.
健康相关的社会需求（HRSNs），如食物或住房无保障，是公共卫生紧急情况下导致结果差异的重要因素。我们描述了在马萨诸塞州波士顿为因 COVID-19 检测而从急诊科出院的患者开发的远程医疗随访计划，以识别临床症状恶化的患者，筛查未满足的 HRSN，并为社会弱势群体提供自我隔离咨询和降低风险的策略。我们优先考虑为有公共医疗保险和没有初级保健医生的患者打电话。在 2020 年 3 月 30 日至 5 月 12 日的前 43 天运营中，我们的干预措施覆盖了 509 名患者，其中 209 名（41.1%）患者报告存在 HRSN，最常见的是与食物、住房或水电费有关。31 名（6.1%）患者需要临床医生评估病情恶化情况。这种公共卫生干预措施可能对其他机构开发针对疑似 COVID-19 出院患者的社会和健康需求的项目有用。
