Implementing Health Related Social Needs Screening in an Outpatient Clinic
Introduction/Objectives: Health-related social needs (HRSN) screening efforts have reported high rates of identified social needs. Little is known if efforts to conduct HRSN screening in resource-constrained federally-qualified health centers (FQHC) successfully captures a representative patient pop...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2022-08-01
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| Series: | Journal of Primary Care & Community Health |
| Online Access: | https://doi.org/10.1177/21501319221118809 |
| _version_ | 1811338974164156416 |
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| author | Raman Nohria Nan Xiao Rubeen Guardado Mari-Lynn Drainoni Cara Smith Keith Nokes Elena Byhoff |
| author_facet | Raman Nohria Nan Xiao Rubeen Guardado Mari-Lynn Drainoni Cara Smith Keith Nokes Elena Byhoff |
| author_sort | Raman Nohria |
| collection | DOAJ |
| description | Introduction/Objectives: Health-related social needs (HRSN) screening efforts have reported high rates of identified social needs. Little is known if efforts to conduct HRSN screening in resource-constrained federally-qualified health centers (FQHC) successfully captures a representative patient population. Methods: This cross-sectional study extracted EMR data from 2016 to 2020 for 4731 screened patients from 7 affiliated clinics of a FQHC. Unscreened patients were pulled as a random sample from the study period. A multivariable logistic regression was used to identify sociodemographic traits, chronic disease diagnoses and burden, and clinic visit type and frequency associated with being screened for HRSN. Results: Our FQHC screened 4731 unique patients or <1% of the total clinic population. Screened patients had a median of 3.3 (±2.5) unmet HRSN. Medicaid patients had higher odds of being screened (aOR = 1.38, CI 1.19-1.61) relative to Medicare patients. The odds of being screened for social needs increased with more provider visits per year: compared to fewer than 1 visit per year, patients with 1 to 3 provider visits (aOR = 2.06, CI 1.73-2.32), 4 to 6 provider visits (aOR = 3.34, CI 2.89-3.87), and more than 6 provider visits (aOR = 5.16, CI 4.35-6.12) all had higher odds of social needs screening. Patients with a higher comorbid disease burden (>2 conditions, aOR = 2.80, CI 2.07-3.79) had higher odds of screening. Conclusions: Our findings demonstrate an increased likelihood to screen patients who visit outpatient services more often and have a higher comorbid disease burden. To meet state-level Medicaid requirements, resource-constrained FQHCs that implement clinic wide HRSN screening may be well served to identify a priori strategies to ensure representative and equitable screening across the patient population. |
| first_indexed | 2024-04-13T18:18:22Z |
| format | Article |
| id | doaj.art-d6f87d9e41744c4d9f5f644996d06c99 |
| institution | Directory Open Access Journal |
| issn | 2150-1327 |
| language | English |
| last_indexed | 2024-04-13T18:18:22Z |
| publishDate | 2022-08-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Primary Care & Community Health |
| spelling | doaj.art-d6f87d9e41744c4d9f5f644996d06c992022-12-22T02:35:34ZengSAGE PublishingJournal of Primary Care & Community Health2150-13272022-08-011310.1177/21501319221118809Implementing Health Related Social Needs Screening in an Outpatient ClinicRaman Nohria0Nan Xiao1Rubeen Guardado2Mari-Lynn Drainoni3Cara Smith4Keith Nokes5Elena Byhoff6Duke University School of Medicine, Durham, NC, USAGreater Lawrence Family Health Center, Lawrence, MA, USATufts University School of Medicine, Boston, MA, USAEvans Center for Implementation and Improvement Sciences, Boston University School of Medicine, Boston, MA, USAGreater Lawrence Family Health Center, Lawrence, MA, USADepartment of Family Medicine, Tufts University School of Medicine, Boston, MA, USADepartment of Medicine, Tufts Medical Center, Boston, MA, USAIntroduction/Objectives: Health-related social needs (HRSN) screening efforts have reported high rates of identified social needs. Little is known if efforts to conduct HRSN screening in resource-constrained federally-qualified health centers (FQHC) successfully captures a representative patient population. Methods: This cross-sectional study extracted EMR data from 2016 to 2020 for 4731 screened patients from 7 affiliated clinics of a FQHC. Unscreened patients were pulled as a random sample from the study period. A multivariable logistic regression was used to identify sociodemographic traits, chronic disease diagnoses and burden, and clinic visit type and frequency associated with being screened for HRSN. Results: Our FQHC screened 4731 unique patients or <1% of the total clinic population. Screened patients had a median of 3.3 (±2.5) unmet HRSN. Medicaid patients had higher odds of being screened (aOR = 1.38, CI 1.19-1.61) relative to Medicare patients. The odds of being screened for social needs increased with more provider visits per year: compared to fewer than 1 visit per year, patients with 1 to 3 provider visits (aOR = 2.06, CI 1.73-2.32), 4 to 6 provider visits (aOR = 3.34, CI 2.89-3.87), and more than 6 provider visits (aOR = 5.16, CI 4.35-6.12) all had higher odds of social needs screening. Patients with a higher comorbid disease burden (>2 conditions, aOR = 2.80, CI 2.07-3.79) had higher odds of screening. Conclusions: Our findings demonstrate an increased likelihood to screen patients who visit outpatient services more often and have a higher comorbid disease burden. To meet state-level Medicaid requirements, resource-constrained FQHCs that implement clinic wide HRSN screening may be well served to identify a priori strategies to ensure representative and equitable screening across the patient population.https://doi.org/10.1177/21501319221118809 |
| spellingShingle | Raman Nohria Nan Xiao Rubeen Guardado Mari-Lynn Drainoni Cara Smith Keith Nokes Elena Byhoff Implementing Health Related Social Needs Screening in an Outpatient Clinic Journal of Primary Care & Community Health |
| title | Implementing Health Related Social Needs Screening in an Outpatient Clinic |
| title_full | Implementing Health Related Social Needs Screening in an Outpatient Clinic |
| title_fullStr | Implementing Health Related Social Needs Screening in an Outpatient Clinic |
| title_full_unstemmed | Implementing Health Related Social Needs Screening in an Outpatient Clinic |
| title_short | Implementing Health Related Social Needs Screening in an Outpatient Clinic |
| title_sort | implementing health related social needs screening in an outpatient clinic |
| url | https://doi.org/10.1177/21501319221118809 |
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