Hare Allison J, Honig Katherine, Cronholm Peter F, Shabazz-McKlaine Samira, Morgan Anna U
Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115. Email:
Am J Manag Care. 2023 Jan 1;29(1):e18-e23. doi: 10.37765/ajmc.2023.89309.
Social determinants have an outsized impact on health outcomes. Given the increasing awareness of this impact and the adoption of alternative payment models that incentivize addressing social needs, expectations are growing that health systems will appropriately screen for patients' social needs. However, there is limited evidence on how patients would like their health systems to engage with them around these needs. Our objective was to understand patient perspectives on completing social needs screening through technology-based modalities.
We performed a qualitative study with semistructured patient interviews from November 2021 to April 2022.
Patients were eligible for our health system's standardized social needs screening survey if they had not completed it in the past year and were scheduled for a nonacute primary care visit. Patients were selected for interview if they completed the survey via portal or tablet or if they were eligible for but did not complete the survey. Interviews were analyzed using an integrated approach. Domains, subdomains, and themes were identified.
We completed interviews with 54 participants. Participants were broadly accepting of screening, and most were comfortable with portal or tablet-based screening. They were motivated to complete the screening and recognized the connection between social needs and health. Having a trusting relationship with their clinician and feeling that their information was private were noted by patients as important factors for process endorsement.
This qualitative study provides insight into patient-centered approaches for identifying patients' social needs.
社会决定因素对健康结果有着巨大影响。鉴于人们对这种影响的认识不断提高，以及采用了激励满足社会需求的替代支付模式，人们越来越期望卫生系统能适当地筛查患者的社会需求。然而，关于患者希望其卫生系统如何围绕这些需求与他们互动的证据有限。我们的目标是了解患者对通过基于技术的方式完成社会需求筛查的看法。
我们于2021年11月至2022年4月对患者进行了半结构化访谈的定性研究。
如果患者在过去一年中未完成我们卫生系统的标准化社会需求筛查调查，且计划进行非急性初级保健就诊，则符合参与我们调查的条件。如果患者通过门户网站或平板电脑完成了调查，或者符合调查条件但未完成调查，则被选为访谈对象。访谈采用综合方法进行分析。确定了领域、子领域和主题。
我们完成了对54名参与者的访谈。参与者普遍接受筛查，大多数人对基于门户网站或平板电脑的筛查感到满意。他们有动力完成筛查，并认识到社会需求与健康之间的联系。患者指出，与临床医生建立信任关系以及感觉自己的信息是私密的是认可该流程的重要因素。
这项定性研究为以患者为中心的识别患者社会需求的方法提供了见解。
