Division of Pediatric Hospital Medicine, Department of Pediatrics, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama.
Section of Pediatric Hospital Medicine, Department of Pediatrics, Saint Louis University, Saint Louis, Missouri.
Hosp Pediatr. 2024 Jul 1;14(7):e304-e307. doi: 10.1542/hpeds.2023-007602.
Food insecurity (FI) has increasingly become a focus for hospitalized patients. The best methods for screening practices, particularly in hospitalized children, are unknown. The purpose of the study was to evaluate results of an electronic medical record (EMR) embedded, brief screening tool for FI among inpatients.
This was a cross-sectional study from August 2020 to September 2022 for all children admitted to a quaternary children's hospital. Primary outcomes were proportion of those screened for FI and those identified to have a positive screen. FI was evaluated by The Hunger Vital Sign, a validated 2-question screen verbally obtained in the nursing intake form in the EMR. Covariates include demographic variables of age, sex, race, ethnicity, primary language, and insurance. Statistical analyses including all univariate outcome and bivariate comparisons were performed with SAS 9.4.
There were 31 553 patient encounters with 81.7% screened for FI. Patients had a median age of 6.3 years, were mostly male (54.2%), White (60.6%), non-Hispanic (92.7%), English-speaking (94.3%), and had government insurance (79.8%). Younger (0-2 years), non-White, and noninsured patients were all screened significantly less often for FI (all P < .001). A total of 3.4% were identified as having FI. Patients who were older, non-White, Hispanic, non-English speaking, and had nonprivate insurance had higher FI (all P < .001).
Despite the use of an EMR screening tool intended to be universal, we found variation in how we screen for FI. At times, we missed those who would benefit the most from intervention, and thus it may be subject to implementation bias.
食物不安全（FI）已逐渐成为住院患者关注的焦点。针对住院患者，最佳的筛查方法，尤其是针对住院儿童的筛查方法，尚未明确。本研究旨在评估一种嵌入电子病历（EMR）中的简短 FI 筛查工具在住院患者中的应用效果。
这是一项 2020 年 8 月至 2022 年 9 月在一家四级儿童医院进行的横断面研究，纳入所有入院儿童。主要结局为 FI 筛查比例和阳性筛查比例。FI 通过 The Hunger Vital Sign 进行评估，这是一种在 EMR 中的护理入院表单中通过口头获取的 2 个问题验证过的筛查工具。协变量包括年龄、性别、种族、民族、主要语言和保险等人口统计学变量。采用 SAS 9.4 进行所有单变量和双变量比较的统计分析。
共纳入 31553 例患者，其中 81.7%接受了 FI 筛查。患者的中位年龄为 6.3 岁，男性占 54.2%，白人占 60.6%，非西班牙裔占 92.7%，英语为主要语言占 94.3%，政府保险占 79.8%。年龄较小（0-2 岁）、非白种人、无保险的患者 FI 筛查频率显著较低（均 P <.001）。共有 3.4%的患者被诊断为 FI。年龄较大、非白种人、西班牙裔、非英语为主要语言和非私人保险的患者 FI 发生率更高（均 P <.001）。
尽管使用了旨在普及的 EMR 筛查工具，但我们发现 FI 的筛查方式存在差异。有时，我们会错过那些最需要干预的患者，因此这可能存在实施偏倚。
