Bechtel Nancie, Jones Alexandria, Kue Jennifer, Ford Jodi L
VA Central Ohio Healthcare System, Columbus, Ohio.
Franklin County Public Health, Columbus, Ohio.
Public Health Nurs. 2022 Mar;39(2):438-445. doi: 10.1111/phn.12983. Epub 2021 Oct 10.
This study evaluated the effects of a social determinants of health (SDH) screening tool and service referral on emergency department (ED) use among patients at a Federally Qualified Health Center primary care clinic.
Quasi-experimental.
Three-hundred and eleven English-speaking patients 18 years and older.
The Core 5 SDH screening tool consists of five yes/no items assessing food, housing, utilities, transportation, and safety needs. The number of ED visits 3 months before and after the intervention were collected from electronic health records.
The research team administered the Core 5 SDH screening tool and if desired, referred patients with an identified need for SDH services.
Approximately 43% of patients reported a SDH need with food insecurity most prevalent (62.2%). The number of ED visits was significantly lower 3 months post-intervention compared to 3 months before for the 125 participants who wanted and received the SDH service referral (IRR = 0.64, 95% CI = 0.41, 0.99) and for the 35 participants who reported receiving some/all of the needed services at the 2-week follow-up (IRR = 0.36, 95% CI = 0.17, 0.76).
Addressing patients' SDH needs may reduce ED visits, lower healthcare costs, and ultimately, improve health.
本研究评估了健康社会决定因素（SDH）筛查工具及服务转诊对一家联邦合格医疗中心初级保健诊所患者急诊就诊情况的影响。
准实验性研究。
311名18岁及以上说英语的患者。
核心5项SDH筛查工具由5个“是/否”项目组成，用于评估食品、住房、水电、交通和安全需求。干预前后3个月的急诊就诊次数从电子健康记录中收集。
研究团队使用核心5项SDH筛查工具，并在需要时为确定有SDH服务需求的患者提供转诊。
约43%的患者报告有SDH需求，其中粮食不安全最为普遍（62.2%）。对于125名希望并接受了SDH服务转诊的参与者，干预后3个月的急诊就诊次数显著低于干预前3个月（风险比=0.64，95%置信区间=0.41，0.99）；对于35名在2周随访中报告接受了部分/全部所需服务的参与者，也是如此（风险比=0.36，95%置信区间=0.17，0.76）。
满足患者的SDH需求可能会减少急诊就诊次数，降低医疗成本，并最终改善健康状况。
