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将社会需求融入医疗保健:实施科学视角

Integrating Social Needs into Health Care: An Implementation Science Perspective.

作者信息

Kepper Maura, Walsh-Bailey Callie, Owens-Jasey Constance, Gunn Rose, Gold Rachel

机构信息

Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, St. Louis, Missouri, USA; email:

Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.

出版信息

Annu Rev Public Health. 2025 Apr;46(1):151-170. doi: 10.1146/annurev-publhealth-071823-111332. Epub 2024 Oct 30.

Abstract

Unmet social needs (e.g., housing instability, food insecurity, transportation barriers) impact a patient's ability to participate in health-seeking behaviors (e.g., physical activity, routine preventive care) and to achieve optimal health. A rapidly growing number of health care systems are incorporating social needs screening and assistance into clinical workflows, yet many implementation and sustainability challenges exist and require collaboration with social service organizations. This review highlights implementation approaches used within this rapidly changing US landscape and uses implementation science frameworks to systematically identify multilevel barriers to and facilitators of implementing and sustaining social needs care. Policies and economic investments are necessary as they determine critical barriers and facilitators within the clinical and social service contexts. Implementation may be further strengthened by cross-sector engagement, evidence-based implementation strategies, and capacity building within clinical and social service organizations. Successful, sustained implementation of social needs care may improve the quality of health care, population health, and health equity.

摘要

未满足的社会需求(如住房不稳定、粮食不安全、交通障碍)会影响患者参与寻求健康行为(如体育活动、常规预防保健)以及实现最佳健康状态的能力。越来越多的医疗保健系统正在将社会需求筛查和援助纳入临床工作流程,但仍存在许多实施和可持续性方面的挑战,需要与社会服务组织合作。本综述强调了在美国这一快速变化的背景下所采用的实施方法,并运用实施科学框架系统地识别实施和维持社会需求护理的多层次障碍和促进因素。政策和经济投资是必要的,因为它们决定了临床和社会服务环境中的关键障碍和促进因素。跨部门参与、基于证据的实施策略以及临床和社会服务组织内部的能力建设可能会进一步加强实施。成功、持续地实施社会需求护理可能会提高医疗保健质量、人群健康水平和健康公平性。

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