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常规和结构化社会需求数据收集在美国医院改善医疗服务中的作用。

The role of routine and structured social needs data collection in improving care in US hospitals.

作者信息

Richwine Chelsea, Patel Vaishali, Everson Jordan, Iott Bradley

机构信息

Office of the Assistant Secretary for Technology Policy, US Department of Health and Human Services, Washington, DC 20201, United States.

Division of General Internal Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI 48109, United States.

出版信息

J Am Med Inform Assoc. 2025 Jan 1;32(1):28-37. doi: 10.1093/jamia/ocae279.

Abstract

OBJECTIVES

To understand how health-related social needs (HRSN) data are collected at US hospitals and implications for use.

MATERIALS AND METHODS

Using 2023 nationally representative survey data on US hospitals (N = 2775), we described hospitals' routine and structured collection and use of HRSN data and examined the relationship between methods of data collection and specific uses. Multivariate logistic regression was used to identify characteristics associated with data collection and use and understand how methods of data collection relate to use.

RESULTS

In 2023, 88% of hospitals collected HRSN data (64% routinely, 72% structured). While hospitals commonly used data for internal purposes (eg, discharge planning, 79%), those that collected data routinely and in a structured format (58%) used data for purposes involving coordination or exchange with other organizations (eg, making referrals, 74%) at higher rates than hospitals that collected data but not routinely or in a non-structured format (eg, 93% vs 67% for referrals, P< .05). In multivariate regression, routine and structured data collection was positively associated with all uses of data examined. Hospital location, ownership, system-affiliation, value-based care participation, and critical access designation were associated with HRSN data collection, but only system-affiliation was consistently (positively) associated with use.

DISCUSSION

While most hospitals screen for social needs, fewer collect data routinely and in a structured format that would facilitate downstream use. Routine and structured data collection was associated with greater use, particularly for secondary purposes.

CONCLUSION

Routine and structured screening may result in more actionable data that facilitates use for various purposes that support patient care and improve community and population health, indicating the importance of continuing efforts to increase routine screening and standardize HRSN data collection.

摘要

目的

了解美国医院如何收集与健康相关的社会需求(HRSN)数据及其使用意义。

材料与方法

利用2023年美国医院的全国代表性调查数据(N = 2775),我们描述了医院对HRSN数据的常规和结构化收集与使用情况,并研究了数据收集方法与特定用途之间的关系。采用多变量逻辑回归来识别与数据收集和使用相关的特征,并了解数据收集方法与使用之间的关系。

结果

2023年,88%的医院收集了HRSN数据(64%为常规收集,72%为结构化收集)。虽然医院通常将数据用于内部目的(如出院计划,79%),但那些常规且以结构化格式收集数据的医院(58%)将数据用于涉及与其他组织协调或交换的目的(如进行转诊,74%)的比例高于那些收集了数据但非常规或非结构化格式收集数据的医院(如转诊方面,93%对67%,P <.05)。在多变量回归中,常规和结构化数据收集与所研究的所有数据用途均呈正相关。医院位置、所有权、系统隶属关系、基于价值的医疗参与情况和关键接入指定与HRSN数据收集相关,但只有系统隶属关系始终(正)与数据使用相关。

讨论

虽然大多数医院筛查社会需求,但较少有医院常规且以结构化格式收集数据,而这种格式有助于下游使用。常规和结构化数据收集与更多的使用相关,特别是对于次要目的。

结论

常规和结构化筛查可能会产生更具可操作性的数据,便于用于支持患者护理以及改善社区和人群健康的各种目的,这表明持续努力增加常规筛查并使HRSN数据收集标准化的重要性。

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