急诊科综合社会风险筛选及资源转介计划。

IF 1.8 3区 医学 Q2 EMERGENCY MEDICINE
Kaytlena Stillman, Alex Dahut, Antonina Caudill, Katie Hren, Krystal Green, Marie Lauzon, Susan Jackman, Alexander Lawton, Tananshi Chopra, Joel Geiderman, Sam Torbati
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引用次数: 0

摘要

简介:急诊科(ED)是筛查和处理患者社会风险的合适场所;然而,目前还不存在标准化的过程。本研究的目的是描述社会风险筛查和资源转介计划的实施和结果,使用全面的筛查问卷。方法:我们于2022年7月至2023年4月在加利福尼亚州洛杉矶的一个学术城市急诊科进行了一项前瞻性队列研究。训练有素的轮班工作人员在早上6点到午夜之间招募急诊科患者,平均每周40小时的覆盖时间,包括周末。结果:共有4277例ED患者被考虑筛查,1677例(39.2%)患者符合条件:1473例(87.8%)患者同意进行社会风险筛查,其中1078例(73.2%)患者在筛查问卷中至少存在一种社会风险。最常见的社会风险报告是社会孤立(39%)和抑郁(23%)。88.9-96.8%的中等社会风险患者通过网络平台成功获得资源。80.8-100%被归为高社会风险的患者在急诊科成功与社工联系。在这个样本中,与男性和白人患者相比,女性患者(比值比[OR] 1.30, 95%置信区间[CI] 1.02-1.67)和黑人患者(比值比[OR] 1.37, 95%置信区间[CI] 1.02-1.85)具有大于一个社会风险的几率显著更高。结论:本研究描述了一个大型城市学术ED的综合社会风险筛查和资源推荐项目的结果。结果将为研究机构的资源优先排序提供信息。这种模式可以作为类似机构使用的基础,同时个性化他们自己的方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Emergency Department Comprehensive Social Risk Screening and Resource Referral Program.

Introduction: The emergency department (ED) is an appropriate location to screen for and address social risks among patients; however, a standardized process does not currently exist. Our objective in this study was to describe the implementation and findings of a social risk screening and resource referral program using a comprehensive screening questionnaire.

Methods: We conducted a prospective, cohort study between July 2022-April 2023 at a single academic, urban ED in Los Angeles, CA. Trained staff on rotating shifts recruited ED patients between 6 am to midnight, with an average of 40 hours of coverage per week including weekends. Patients were excluded if they were <18 years of age, could not provide informed consent, or were deemed too medically unstable. Trained staff screened eligible consenting patients at ED bedside for social risks within 12 different domains of social determinants of health using a 19-question survey. Personalized resources were provided through an online platform or through direct communication with a social worker. Demographic data and patient responses were recorded in a deidentified database. We used a univariate logistic regression analysis to evaluate associations between demographic information and burden of social risk.

Results: A total of 4,277 ED patients were considered for screening, and 1,677 (39.2%) were eligible: 1,473 (87.8%) patients consented to social risk screening, and 1,078 (73.2%) of them had at least one social risk as indicated by the screening questionnaire. The most commonly reported social risks were social isolation (39%) and depression (23%). Between 88.9-96.8% of patients categorized as medium social risk were successfully provided resources through the online platform. Between 80.8-100% of patients categorized into high social risk had successfully connected with a social worker while in the ED. In this sample, there were significantly higher odds of having greater than one social risk for female (odds ratio [OR] 1.30, 95% confidence interval [CI] 1.02-1.67) and Black patients (OR 1.37, 95% CI 1.02-1.85) compared to male and White patients, respectively.

Conclusion: This study describes the findings from a comprehensive social risk screening and resource referral program at a large, urban, academic ED. The results will inform resource prioritization at the study institution. This model can serve as a basis for similar institutions to use, while individualizing their own approach.

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来源期刊
Western Journal of Emergency Medicine
Western Journal of Emergency Medicine Medicine-Emergency Medicine
CiteScore
5.30
自引率
3.20%
发文量
125
审稿时长
16 weeks
期刊介绍: WestJEM focuses on how the systems and delivery of emergency care affects health, health disparities, and health outcomes in communities and populations worldwide, including the impact of social conditions on the composition of patients seeking care in emergency departments.
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