Luther Brenda L, Bybee Sara G, Elmore Catherine E, Grigorian Ernest, Wang Ching-Yu, Butler Jorie M, Wallace Andrea S
College of Nursing, The University of Utah, Salt Lake City, Utah.
School of Medicine, The University of Utah, Salt Lake City, Utah.
AJPM Focus. 2025 Apr 11;4(4):100346. doi: 10.1016/j.focus.2025.100346. eCollection 2025 Aug.
Achieving health equity necessitates addressing social determinants of health. Value-based payment models encourage healthcare systems to address patients' health-related social needs such as housing, food, and transportation. Leading organizations advocate for integrating social needs screening in clinical care to connect patients with necessary services. This study aimed to explore patients' experiences and motivations for completing social needs screening during clinical visits and engaging with community service navigators. The goal is to inform more effective health system strategies for addressing social needs and ultimately enhance population health.
This is a qualitative descriptive study involving clinical visits to adult or pediatric emergency departments or mobile clinics and COVID-19 testing sites within a large tertiary academic healthcare system in the intermountain U.S. Sixty-three patients (30 Spanish speaking and 33 English speaking) who screened positive for social needs were involved. Telephone interviews were conducted with participants who screened positive for social needs and who were referred to service navigators for community resources. Data were analyzed using NVIVO software, identifying key themes through open coding and consensus among content experts.
The results revealed that social needs screening facilitated the development of meaningful relationships, making patients feel cared for and supported. Patients initially had low expectations but were often pleasantly surprised and relieved by the resources provided. Although some patients successfully obtained the necessary resources, these sentiments were balanced by others who experienced discomfort or suspicion regarding the screening process. In addition, some patients encountered barriers such as ineligibility, technological challenges, and emotional burdens, which led to frustration and discouragement.
Effective health-related social needs screening and referral processes can foster positive patient relationships and address significant social needs. However, the manner of screening and the support provided for navigating resources are crucial. Enhanced support systems are essential to overcome referral barriers and ensure that patients can access necessary services, contributing to improved health equity and reduced disparities.
实现健康公平需要解决健康的社会决定因素。基于价值的支付模式鼓励医疗保健系统满足患者与健康相关的社会需求，如住房、食物和交通。领先的组织倡导将社会需求筛查纳入临床护理，以便为患者连接必要的服务。本研究旨在探讨患者在临床就诊期间完成社会需求筛查并与社区服务导航员互动的经历和动机。目标是为解决社会需求的更有效的卫生系统策略提供信息，并最终改善人群健康。
这是一项定性描述性研究，涉及对美国中西部一个大型三级学术医疗保健系统内的成人或儿科急诊科、移动诊所和新冠病毒检测点的临床就诊。63名社会需求筛查呈阳性的患者（30名说西班牙语，33名说英语）参与其中。对社会需求筛查呈阳性并被转介给社区资源服务导航员的参与者进行了电话访谈。使用NVIVO软件对数据进行分析，通过开放编码和内容专家之间的共识确定关键主题。
结果显示，社会需求筛查促进了有意义关系的发展，让患者感到被关心和支持。患者最初期望不高，但往往对提供的资源感到惊喜和宽慰。虽然一些患者成功获得了必要的资源，但也有其他患者对筛查过程感到不适或怀疑，这种情绪与之相平衡。此外，一些患者遇到了诸如不符合资格、技术挑战和情感负担等障碍，这导致了沮丧和气馁。
有效的与健康相关的社会需求筛查和转介流程可以促进积极的医患关系，并满足重大的社会需求。然而，筛查方式和提供的资源导航支持至关重要。加强支持系统对于克服转介障碍并确保患者能够获得必要服务至关重要，有助于改善健康公平性并减少差距。
