Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Utah (EM Keating, M Holsti, and JA Robison), Salt Lake City, Utah; Intermountain Primary Children's Hospital (NJ Tedford, EM Keating, M Holsti, and JA Robison), Salt Lake City, Utah.
Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Utah (EM Keating, M Holsti, and JA Robison), Salt Lake City, Utah; Intermountain Primary Children's Hospital (NJ Tedford, EM Keating, M Holsti, and JA Robison), Salt Lake City, Utah.
Acad Pediatr. 2022 Nov-Dec;22(8):1318-1327. doi: 10.1016/j.acap.2022.05.002. Epub 2022 May 7.
To determine the prevalence of unmet social needs (USN) in a pediatric emergency department (PED) patient population and examine disparities in USN by self-selected language and patient demographics.
We surveyed a convenience sample of English- and Spanish-speaking caregivers of patients <18-years-old presenting to a free-standing children's hospital in Salt Lake City, Utah. In the caregiver's self-selected language, the pediatric version of the Screener for Intensifying Community Referrals for Health (p-SINCERE) assessed patient demographics and 10 areas of social needs. The primary outcome was presence of USN. Descriptive statistics compared 1) self-selected languages and 2) absence versus presence of USN. Patient and caregiver-level risk factors associated with USN were identified using multivariable logistic regression.
Of the 10,156 patients seen in our PED from 04/01/2021 to 08/03/2021, there were 9922 eligible, 5357 approached, and 3987 enrolled caregivers. Of the 3987 caregivers enrolled, self-selected language was English for 3662 (91.8%) and Spanish for 325 (8.2%). There were 1680 enrolled caregivers with ≥1 USN, representing 39.7% of English-speaking and 70.2% of Spanish-speaking caregivers (P < .001). The odds of having ≥1 USN was more than 2 times higher in Spanish-speakers than in English-speakers after adjustment.
USN are common for families presenting for care to a PED, especially among Spanish-speaking caregivers. Furthermore, this study demonstrates disparities in limited English proficiency, race and ethnicity, and child insurance status. These findings support the practicality of utilizing the PED as an access point to initiate social need screening and referrals to address social determinants of health and health disparities.
确定儿科急诊患者人群中未满足的社会需求（USN）的患病率，并按自我选择的语言和患者人口统计学特征检查 USN 的差异。
我们对在犹他州盐湖城一家独立儿童医院就诊的 18 岁以下英语和西班牙语患者的看护者进行了便利抽样调查。在看护者自行选择的语言中，儿科版社区强化转介筛查工具（p-SINCERE）评估了患者人口统计学特征和 10 个社会需求领域。主要结果是存在 USN。使用描述性统计比较了 1）自我选择的语言和 2）USN 缺失与存在的情况。使用多变量逻辑回归确定与 USN 相关的患者和看护者层面的风险因素。
在我们的儿科急诊部于 2021 年 4 月 1 日至 8 月 3 日期间接诊的 10156 名患者中，有 9922 名符合条件，3662 名（91.8%）选择英语，325 名（8.2%）选择西班牙语。3987 名登记的看护者中，有 1680 名至少存在 1 项 USN，占英语看护者的 39.7%和西班牙语看护者的 70.2%（P<.001）。调整后，西班牙语使用者的 USN 发生率是英语使用者的两倍以上。
在儿科急诊就诊的家庭中，USN 很常见，尤其是西班牙语使用者。此外，本研究还表明，英语水平有限、种族和民族以及儿童保险状况方面存在差异。这些发现支持利用儿科急诊作为切入点，启动社会需求筛查和转介，以解决健康和健康差异的社会决定因素的实用性。
