Social Determinants of Health Screening at an Urban Emergency Department Urgent Care During COVID-19
Introduction: Social determinants of health (SDoH) impact patients’ health outcomes, yet screening methods in emergency departments (ED) are not consistent or standardized. The SDoH-related health disparities may have widened during the coronavirus 2019 (COVID-19) pandemic, especially among patients...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
eScholarship Publishing, University of California
2023-06-01
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| Series: | Western Journal of Emergency Medicine |
| Online Access: | https://escholarship.org/uc/item/6jt4h6zp |
| _version_ | 1797766896381067264 |
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| author | Haeyeon Hong Kalpana Narayan Shankar Andrew Thompson Pablo Buitron De La Vega Rashmi Koul Emily C. Cleveland Manchanda Sorraya Jaiprasert Samantha Roberts Tyler Pina Emily Anderson Jessica Lin Gabrielle A. Jacquet |
| author_facet | Haeyeon Hong Kalpana Narayan Shankar Andrew Thompson Pablo Buitron De La Vega Rashmi Koul Emily C. Cleveland Manchanda Sorraya Jaiprasert Samantha Roberts Tyler Pina Emily Anderson Jessica Lin Gabrielle A. Jacquet |
| author_sort | Haeyeon Hong |
| collection | DOAJ |
| description | Introduction: Social determinants of health (SDoH) impact patients’ health outcomes, yet screening methods in emergency departments (ED) are not consistent or standardized. The SDoH-related health disparities may have widened during the coronavirus 2019 (COVID-19) pandemic, especially among patients who primarily receive their medical care in EDs. We sought to identify SDoH among ED urgent care patients during the COVID-19 pandemic at an urban safety-net hospital, assess the impact of the pandemic on their SDoH, study the feasibility of SDoH screening and resource referrals, and identify preferred methods of resource referrals and barriers to accessing resources. Methods: Research assistants screened ED urgent care patients using a validated SDoH screener, inquiring about the impact of COVID-19 on their SDoH. A printed resource guide was provided. Two weeks later, a follow-up telephone survey assessed for barriers to resource connection and patients’ preferred methods for resource referrals. This study was deemed exempt by our institutional review board. Results: Of the 418 patients presented with a screener, 414 (99.0%) patients completed the screening. Of those screened, 296 (71.5%) reported at least one adverse SDoH, most commonly education (38.7%), food insecurity (35.3%), and employment (31.0%). Housing insecurity was reported by 21.0%. Over half of patients (57.0%) endorsed COVID-19 affecting their SDoH. During follow-up, 156 of 234 (67%) attempted calls were successful and 36/156 (23.1%) reported attempting to connect with a resource, with most attempts made for stable housing (11.0%) and food (7.7%). Reasons for not contacting the provided resources included lack of time (37.8%) and forgetting to do so (26.3%). Patients preferred resource guides to be printed (34.0%) and sent via text message to their mobile devices (25.6%). Conclusion: Many urgent care patients of this urban ED reported at least one adverse SDoH, the majority of which were exacerbated by the COVID-19 pandemic. This finding further emphasizes the need to allocate more resources to standardize and expand SDoH screening in EDs. Additionally, hospitals should increase availability of printed or electronic SDoH resource guides, resource navigators, and interpreters both during and after ED visits. |
| first_indexed | 2024-03-12T20:31:54Z |
| format | Article |
| id | doaj.art-0889dbd2a8e0450d988f640771047aae |
| institution | Directory Open Access Journal |
| issn | 1936-9018 |
| language | English |
| last_indexed | 2024-03-12T20:31:54Z |
| publishDate | 2023-06-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Western Journal of Emergency Medicine |
| spelling | doaj.art-0889dbd2a8e0450d988f640771047aae2023-08-01T21:19:03ZengeScholarship Publishing, University of CaliforniaWestern Journal of Emergency Medicine1936-90182023-06-0124410.5811/westjem.59068wjem-24-675Social Determinants of Health Screening at an Urban Emergency Department Urgent Care During COVID-19Haeyeon Hong0Kalpana Narayan Shankar1Andrew Thompson2Pablo Buitron De La Vega3Rashmi Koul4Emily C. Cleveland Manchanda5Sorraya Jaiprasert6Samantha Roberts7Tyler Pina8Emily Anderson9Jessica Lin10Gabrielle A. Jacquet11Boston Medical Center, Department of Emergency Medicine, Boston, MassachusettsBrigham and Women’s Hospital, Department of Emergency Medicine, Boston, MassachusettsBoston Medical Center, Department of Emergency Medicine, Boston, MassachusettsBoston University School of Medicine, Department of Internal Medicine, Boston, MassachusettsBoston Medical Center, Department of Emergency Medicine, Boston, MassachusettsBoston Medical Center, Department of Emergency Medicine, Boston, MassachusettsBoston Medical Center, Department of Emergency Medicine, Boston, MassachusettsBoston Medical Center, Department of Emergency Medicine, Boston, MassachusettsBoston Medical Center, Department of Emergency Medicine, Boston, MassachusettsBoston University School of Medicine, Boston, MassachusettsBoston University School of Medicine, Boston, MassachusettsBoston Medical Center, Department of Emergency Medicine, Boston, MassachusettsIntroduction: Social determinants of health (SDoH) impact patients’ health outcomes, yet screening methods in emergency departments (ED) are not consistent or standardized. The SDoH-related health disparities may have widened during the coronavirus 2019 (COVID-19) pandemic, especially among patients who primarily receive their medical care in EDs. We sought to identify SDoH among ED urgent care patients during the COVID-19 pandemic at an urban safety-net hospital, assess the impact of the pandemic on their SDoH, study the feasibility of SDoH screening and resource referrals, and identify preferred methods of resource referrals and barriers to accessing resources. Methods: Research assistants screened ED urgent care patients using a validated SDoH screener, inquiring about the impact of COVID-19 on their SDoH. A printed resource guide was provided. Two weeks later, a follow-up telephone survey assessed for barriers to resource connection and patients’ preferred methods for resource referrals. This study was deemed exempt by our institutional review board. Results: Of the 418 patients presented with a screener, 414 (99.0%) patients completed the screening. Of those screened, 296 (71.5%) reported at least one adverse SDoH, most commonly education (38.7%), food insecurity (35.3%), and employment (31.0%). Housing insecurity was reported by 21.0%. Over half of patients (57.0%) endorsed COVID-19 affecting their SDoH. During follow-up, 156 of 234 (67%) attempted calls were successful and 36/156 (23.1%) reported attempting to connect with a resource, with most attempts made for stable housing (11.0%) and food (7.7%). Reasons for not contacting the provided resources included lack of time (37.8%) and forgetting to do so (26.3%). Patients preferred resource guides to be printed (34.0%) and sent via text message to their mobile devices (25.6%). Conclusion: Many urgent care patients of this urban ED reported at least one adverse SDoH, the majority of which were exacerbated by the COVID-19 pandemic. This finding further emphasizes the need to allocate more resources to standardize and expand SDoH screening in EDs. Additionally, hospitals should increase availability of printed or electronic SDoH resource guides, resource navigators, and interpreters both during and after ED visits.https://escholarship.org/uc/item/6jt4h6zp |
| spellingShingle | Haeyeon Hong Kalpana Narayan Shankar Andrew Thompson Pablo Buitron De La Vega Rashmi Koul Emily C. Cleveland Manchanda Sorraya Jaiprasert Samantha Roberts Tyler Pina Emily Anderson Jessica Lin Gabrielle A. Jacquet Social Determinants of Health Screening at an Urban Emergency Department Urgent Care During COVID-19 Western Journal of Emergency Medicine |
| title | Social Determinants of Health Screening at an Urban Emergency Department Urgent Care During COVID-19 |
| title_full | Social Determinants of Health Screening at an Urban Emergency Department Urgent Care During COVID-19 |
| title_fullStr | Social Determinants of Health Screening at an Urban Emergency Department Urgent Care During COVID-19 |
| title_full_unstemmed | Social Determinants of Health Screening at an Urban Emergency Department Urgent Care During COVID-19 |
| title_short | Social Determinants of Health Screening at an Urban Emergency Department Urgent Care During COVID-19 |
| title_sort | social determinants of health screening at an urban emergency department urgent care during covid 19 |
| url | https://escholarship.org/uc/item/6jt4h6zp |
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