Nancie Bechtel, Alexandria Jones, Jennifer Kue, Jodi L Ford
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引用次数: 8
摘要
目的:本研究评估了健康社会决定因素(SDH)筛查工具和服务转诊对联邦合格卫生中心初级保健诊所患者急诊科(ED)使用的影响。研究设计:准实验。样本:311名18岁及以上说英语的患者。措施:Core 5 SDH筛选工具由5个是/否项目组成,评估食品、住房、公用事业、交通和安全需求。从电子健康记录中收集干预前后3个月的急诊科就诊次数。干预:研究小组使用Core 5 SDH筛查工具,如果需要,转诊需要SDH服务的患者。结果:大约43%的患者报告了SDH需求,其中食品不安全最为普遍(62.2%)。干预后3个月,与3个月前相比,125名希望并接受SDH服务推荐的参与者(IRR = 0.64, 95% CI = 0.41, 0.99)和35名在2周随访中报告接受部分/全部所需服务的参与者(IRR = 0.36, 95% CI = 0.17, 0.76)的ED就诊次数显着降低。结论:满足患者的SDH需求可以减少急诊科就诊,降低医疗成本,并最终改善健康。
Evaluation of the core 5 social determinants of health screening tool.
Objective: This study evaluated the effects of a social determinants of health (SDH) screening tool and service referral on emergency department (ED) use among patients at a Federally Qualified Health Center primary care clinic.
Study design: Quasi-experimental.
Sample: Three-hundred and eleven English-speaking patients 18 years and older.
Measures: The Core 5 SDH screening tool consists of five yes/no items assessing food, housing, utilities, transportation, and safety needs. The number of ED visits 3 months before and after the intervention were collected from electronic health records.
Intervention: The research team administered the Core 5 SDH screening tool and if desired, referred patients with an identified need for SDH services.
Results: Approximately 43% of patients reported a SDH need with food insecurity most prevalent (62.2%). The number of ED visits was significantly lower 3 months post-intervention compared to 3 months before for the 125 participants who wanted and received the SDH service referral (IRR = 0.64, 95% CI = 0.41, 0.99) and for the 35 participants who reported receiving some/all of the needed services at the 2-week follow-up (IRR = 0.36, 95% CI = 0.17, 0.76).
Conclusions: Addressing patients' SDH needs may reduce ED visits, lower healthcare costs, and ultimately, improve health.