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住院患者健康社会决定因素筛查:一项质量改进举措。

Inpatient screening for social determinants of health: A quality improvement initiative.

作者信息

Kliewer Dana, McGillen Brian

机构信息

Department of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA.

出版信息

J Clin Transl Sci. 2024 Jun 3;8(1):e104. doi: 10.1017/cts.2024.552. eCollection 2024.

Abstract

INTRODUCTION

Social determinants of health (SDOH) can contribute to disparities that negatively impact health outcomes and healthcare utilization. Comprehensive screening is frequently overlooked during inpatient clinical care. This pilot aimed to evaluate the capturability of a multi-domain SDOH screening tool during hospitalization, as well as correlation of SDOH needs to readmissions.

METHODS

The Protocol for Responding to and Assessing Patients' Assets, Risks and Experiences (PRAPARE) screening tool was implemented on admission with adult inpatients at an academic tertiary medical center in central Pennsylvania. A total of 80 patients were screened over an 8-week period using the PRAPARE tool.

RESULTS

43.7% of participants were identified as having at least one SDOH need and 21.2% were identified as having two or more needs. Of the participants identified as having at least one SDOH need through PRAPARE screening, 42.5% experienced a readmission within 30 days, compared to 15% readmissions among participants with no identified SDOH needs. For each additional SDOH need a patient had, the odds they experienced a readmission increased by 2.2 times.

CONCLUSIONS

The study findings suggest that utilization of the PRAPARE screening tool has the ability to capture significant SDOH needs among hospitalized patients. This study also suggests that higher SDOH needs correlate to increased odds of experiencing a hospital readmission.

摘要

引言

健康的社会决定因素(SDOH)会导致差异,对健康结果和医疗保健利用产生负面影响。在住院临床护理期间,全面筛查常常被忽视。本试点研究旨在评估一种多领域SDOH筛查工具在住院期间的可捕获性,以及SDOH需求与再入院之间的相关性。

方法

在宾夕法尼亚州中部一家学术性三级医疗中心,对成年住院患者入院时实施了患者资产、风险和经历应对与评估协议(PRAPARE)筛查工具。在为期8周的时间里,使用PRAPARE工具对总共80名患者进行了筛查。

结果

43.7%的参与者被确定至少有一项SDOH需求,21.2%的参与者被确定有两项或更多需求。通过PRAPARE筛查被确定至少有一项SDOH需求的参与者中,42.5%在30天内再次入院,而未被确定有SDOH需求的参与者中再入院率为15%。患者每增加一项SDOH需求,其再次入院的几率就会增加2.2倍。

结论

研究结果表明,使用PRAPARE筛查工具能够发现住院患者中显著的SDOH需求。本研究还表明,更高的SDOH需求与更高的再次入院几率相关。

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