Addressing Health-Related Social Needs in Hospitalized Children: An Implementation Assessment.

IF 2.8 3区 医学 Q1 PEDIATRICS
Hemen Muleta, Samantha Levano, Jessica Haughton, Renee Whiskey-LaLanne, Miya Lemberg, Tara Buckenmyer, Patricia A Hametz, Michael L Rinke, Shivani Agarwal, Kevin P Fiori
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引用次数: 0

Abstract

Introduction: High rates of unmet health-related social needs (HRSNs) have been reported among hospitalized children. Community health workers (CHWs) embedded within health systems can assist families with unmet HRSNs. This study evaluated an inpatient HRSNs screening, referral, and CHW resource navigation intervention in a hospital in Bronx County, New York.

Methods: We conducted a retrospective study of hospitalized families between December 2023 and November 2024. Patients were screened for HRSNs upon admission and referred to CHWs after self-reporting unmet HRSNs and confirming they wanted help. We evaluated the intervention using descriptive statistics and Periodic Reflections (PR) analysis following the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) implementation framework.

Results: Of 5,350 admitted patients, 3,291 (61.6%) were screened for HRSNs with 986 (30.0%) screened patients reporting unmet HRSNs. Of the admitted patients, 670 (12.5%) were referred to CHWs and 491 (73.3% of those referred) accepted CHW navigation. Of the CHW navigated patients, 484 (98.6%) were either connected or equipped to connect to social services. Of patients connected to services, 183 (96.8%) self-reported that their HRSNs were improved or resolved. The estimated annual cost of the intervention was $180.63 (IQR $154.58-$180.63) per patient connected with CHWs. PR analysis identified facilitators and barriers to adoption.

Conclusion: Most hospitalized families were screened and those with unmet HRSNs were appropriately referred to CHWs. CHWs were successful in helping families connect to social services, leading to improved or resolved HRSNs. Future research should evaluate the impact of CHW support for unmet HRSNs on child health and healthcare utilization.

解决住院儿童健康相关的社会需求:一项实施评估。
导读:据报道,住院儿童未满足健康相关社会需求的比例很高。卫生系统内的社区卫生工作者(CHWs)可以帮助未满足hrsn的家庭。本研究评估了纽约布朗克斯县一家医院住院患者HRSNs筛查、转诊和CHW资源导航干预。方法:对2023年12月至2024年11月住院患者家属进行回顾性研究。患者在入院时进行hrsn筛查,在自我报告未达到hrsn并确认他们需要帮助后转介到卫生保健中心。我们根据RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance)实施框架,使用描述性统计和周期性反思(PR)分析来评估干预措施。结果:在5350名住院患者中,3291名(61.6%)接受了HRSNs筛查,986名(30.0%)接受筛查的患者报告HRSNs未达到要求。在入院患者中,670例(12.5%)被转介到CHW, 491例(73.3%)接受了CHW导航。在CHW导航的患者中,484例(98.6%)连接或配备连接社会服务。在接受服务的患者中,183人(96.8%)自我报告其HRSNs得到改善或解决。估计每年干预费用为每名与卫生保健有关的患者180.63美元(IQR $154.58- 180.63美元)。PR分析确定了采用的促进因素和障碍。结论:对大多数住院家庭进行了筛查,未达到HRSNs的家庭应适当转介到卫生保健中心。保健员成功地帮助家庭与社会服务联系起来,从而改善或解决了hrsn。未来的研究应评估卫生工作者对未满足的HRSNs的支持对儿童健康和医疗保健利用的影响。
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来源期刊
Academic Pediatrics
Academic Pediatrics PEDIATRICS-
CiteScore
4.60
自引率
12.90%
发文量
300
审稿时长
60 days
期刊介绍: Academic Pediatrics, the official journal of the Academic Pediatric Association, is a peer-reviewed publication whose purpose is to strengthen the research and educational base of academic general pediatrics. The journal provides leadership in pediatric education, research, patient care and advocacy. Content areas include pediatric education, emergency medicine, injury, abuse, behavioral pediatrics, holistic medicine, child health services and health policy,and the environment. The journal provides an active forum for the presentation of pediatric educational research in diverse settings, involving medical students, residents, fellows, and practicing professionals. The journal also emphasizes important research relating to the quality of child health care, health care policy, and the organization of child health services. It also includes systematic reviews of primary care interventions and important methodologic papers to aid research in child health and education.
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