Erie Family Health Centers, Chicago, IL, USA.
AllianceChicago, Chicago, IL, USA.
J Gen Intern Med. 2024 Jan;39(1):128-132. doi: 10.1007/s11606-023-08404-z. Epub 2023 Sep 15.
Programs to screen for social and economic needs (SENs) are challenging to implement.
To describe implementation of an SEN screening program for patients obtaining care at a federally qualified health center (FQHC).
Large Chicago-area FQHC where many patients are Hispanic/Latino and insured through Medicaid.
In the program's phase 1 (beginning April 2020), a prescreening question asked about patients' interest in receiving community resources; staff then called interested patients. After several refinements (e.g., increased staffing, tailored reductions in screening frequency) to address challenges such as a large screening backlog, program phase 2 began in February 2021. In phase 2, a second prescreening question asked about patients' preferred modality to learn about community resources (text/email versus phone calls).
During phase 1, 8925 of 29,861 patients (30%) expressed interest in community resources. Only 40% of interested patients were successfully contacted and screened. In phase 2, 5781 of 21,737 patients (27%) expressed interest in resources; 84% of interested patients were successfully contacted by either text/email (43%) or phone (41%).
Under one-third of patients obtaining care at an FQHC expressed interest in community resources for SENs. After program refinements, rates of follow-up with interested patients substantially increased.
筛查社会和经济需求(SENs)的项目实施起来具有挑战性。
描述在一家合格的联邦健康中心(FQHC)接受治疗的患者中实施 SEN 筛查项目的情况。
位于芝加哥地区的大型 FQHC,许多患者是西班牙裔/拉丁裔,通过医疗补助计划获得保险。
在项目的第一阶段(始于 2020 年 4 月),一个预筛查问题询问了患者对接受社区资源的兴趣;然后工作人员给有兴趣的患者打电话。在针对大筛查积压等挑战进行了几次改进(例如增加人员配备、有针对性地减少筛查频率)后,项目的第二阶段于 2021 年 2 月开始。在第二阶段,第二个预筛查问题询问了患者了解社区资源的首选方式(短信/电子邮件与电话)。
在第一阶段,29861 名患者中有 8925 名(30%)表示对社区资源感兴趣。只有 40%的感兴趣患者成功联系并接受了筛查。在第二阶段,21737 名患者中有 5781 名(27%)对资源感兴趣;通过短信/电子邮件(43%)或电话(41%)成功联系到感兴趣的患者的比例为 84%。
在获得 FQHC 护理的患者中,只有三分之一表示对 SENs 的社区资源感兴趣。在项目改进后,与感兴趣的患者进行随访的比例大大增加。