Kaiser Permanente Washington Health Research Institute, Seattle, Washington
Kaiser Permanente Washington Health Research Institute, Seattle, Washington.
Ann Fam Med. 2022 Mar-Apr;20(2):137-144. doi: 10.1370/afm.2774.
Because social conditions such as food insecurity and housing instability shape health outcomes, health systems are increasingly screening for and addressing patients' social risks. This study documented the prevalence of social risks and examined the desire for assistance in addressing those risks in a US-based integrated delivery system.
A survey was administered to Kaiser Permanente members on subsidized exchange health insurance plans (2018-2019). The survey included questions about 4 domains of social risks, desire for help, and attitudes. We conducted a descriptive analysis and estimated multivariate modified Poisson regression models.
Of 438 participants, 212 (48%) reported at least 1 social risk factor. Housing instability was the most common (70%) factor reported. Members with social risks reported more discomfort being screened for social risks (14.2% vs 5.4%; = .002) than those without risks, although 90% of participants believed that health systems should assist in addressing social risks. Among those with 1-2 social risks, however, only 27% desired assistance. Non-Hispanic Black participants who reported a social risk were more than twice as likely to desire assistance compared with non-Hispanic White participants (adjusted relative risk [RR] 2.2; 95% CI, 1.3-3.8).
Athough most survey participants believed health systems have a role in addressing social risks, a minority of those reporting a risk wanted assistance and reported more discomfort being screened for risk factors than those without risks. Health systems should work to increase the comfort of patients in reporting risks, explore how to successfully assist them when desired, and offer resources to address these risks outside the health care sector..
由于食物无保障和住房不稳定等社会条件会影响健康结果，因此卫生系统越来越多地对患者的社会风险进行筛查并加以处理。本研究记录了美国综合医疗系统中社会风险的普遍程度，并探讨了患者对处理这些风险的帮助的需求。
对参加 Kaiser Permanente 基于补贴的交换健康保险计划的成员（2018-2019 年）进行了一项调查。该调查包括 4 个社会风险领域、帮助需求和态度相关的问题。我们进行了描述性分析并估计了多变量修正泊松回归模型。
在 438 名参与者中，有 212 名（48%）报告了至少 1 个社会风险因素。住房不稳定是报告最多的（70%）因素。有社会风险的成员报告在筛查社会风险方面感到更不适（14.2%比 5.4%； =.002），尽管 90%的参与者认为卫生系统应该协助处理社会风险。然而，在有 1-2 个社会风险的人群中，只有 27%的人希望得到帮助。报告有社会风险的非西班牙裔黑人参与者比非西班牙裔白人参与者更有可能希望得到帮助（调整后的相对风险 [RR] 2.2；95%CI，1.3-3.8）。
尽管大多数调查参与者认为卫生系统在处理社会风险方面发挥了作用，但报告有风险的人中只有少数人希望得到帮助，并且报告在筛查风险因素方面感到不适的人比没有风险的人多。卫生系统应努力提高患者报告风险的舒适度，探讨在需要时如何成功协助他们，并为解决这些风险提供医疗保健部门以外的资源。
