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儿童健康检查中的健康筛查社会决定因素:一项在新冠疫情期间实施的试点项目

Social Determinants of Health Screening at Well Child Visits: A Pilot Program Implemented During the COVID-19 Pandemic.

作者信息

David Pyone, Qureshi Nadia K, Ha Lina, Goldberg Vera, McCune Erin, Wojtowicz Jennifer, Sullivan Katlyn, Sigman Garry, O'Keefe Julie C

机构信息

Loyola University Medical Center, Maywood, IL, USA.

Loyola University Chicago, Maywood, IL, USA.

出版信息

Glob Pediatr Health. 2021 Nov 30;8:2333794X211060971. doi: 10.1177/2333794X211060971. eCollection 2021.

Abstract

This study demonstrates the challenges of establishing social determinants of health (SDH) screening at well child visits (WCVs) during the COVID-19 pandemic. We conducted a 6-month pre-intervention retrospective chart review (2/2020-8/2020) and 6-month post-intervention prospective chart review (8/2020-2/2021) of an SDH screening and referral protocol at a single suburban academic pediatric clinic. WCVs were screened for food, financial, and transportation needs. With the new protocol, 46% of eligible WCVs (n = 1253/2729) had documented screening results. Self-report of screened visits found 34.6% with financial strain, 32% with worry about food insecurity, 25.1% with food insecurity, 5.3% with medical transportation difficulties, and 6% with daily living transportation difficulties. There was an increase in resources offered during the post-intervention period (OR = 11.5 [7.1-18.6],  < .001). There was also an increase in resident physician self-reported knowledge in providing referrals ( = .04).

摘要

本研究展示了在新冠疫情期间于儿童健康检查(WCV)时开展健康社会决定因素(SDH)筛查所面临的挑战。我们对一家郊区学术性儿科诊所的一项SDH筛查及转诊方案进行了为期6个月的干预前回顾性病历审查(2020年2月至2020年8月)和为期6个月的干预后前瞻性病历审查(2020年8月至2021年2月)。对WCV进行了食物、经济和交通需求方面的筛查。采用新方案后,46%的符合条件的WCV(n = 1253/2729)有记录在案的筛查结果。对已筛查就诊的自我报告发现,34.6%存在经济压力,32%担心粮食不安全,25.1%存在粮食不安全,5.3%有医疗交通困难,6%有日常生活交通困难。干预后期提供的资源有所增加(比值比=11.5[7.1 - 18.6],P<0.001)。住院医师在提供转诊方面自我报告的知识也有所增加(P = 0.04)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e0f/8637370/3b3447aa79c3/10.1177_2333794X211060971-fig1.jpg

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