Collection and Use of Social Determinants of Health Data in Inpatient General Internal Medicine Wards: A Scoping Review

Davis, Victoria; Rodger, Laura; Pinto, Andrew D.

doi:10.1007/s11606-022-07937-z

Cited by 6 publications

(6 citation statements)

References 58 publications

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“…[15][16][17] Hospitals have identified HRSNs as a priority, and many have allocated the will and resources to design, develop, and deliver population-level interventions. 3,7,9,[18][19][20] Although some studies have examined the prevalence of screening practices, 8 information on hospital organizational characteristics associated with these practices is nascent. 21 This study leverages national hospital survey data to identify which organizational characteristics and financial arrangements are associated with HRSN screening practices, the internal strategies and programs developed to address them, and external partnerships developed to address the greater context of SDOH.…”

Section: Introductionmentioning

confidence: 99%

“…These include temporary housing vouchers, ridesharing or financial assistance to cover public transportation fares, and access to food pantries to provide short-term alleviation for patients at high risk of adverse outcomes who present with multiple HRSNs . Hospitals have identified HRSNs as a priority, and many have allocated the will and resources to design, develop, and deliver population-level interventions …”

Section: Introductionmentioning

confidence: 99%

“…Burgeoning pressures to shift health services from a payment-based system to value-based care (VBC) have prompted organizational interventions targeting patient population health, 5 , 6 including HRSN screening and referrals to local partners or community-based organization to address related concerns or barriers. 7 Hospitals, health care systems, and institutions are addressing both HRSNs 8 , 9 and SDOH. 10 Based on recent studies reporting that addressing HRSNs is associated with improved patient satisfaction, overall health, and quality of life, as well as with reduced unnecessary patient spending, such as readmission and urgent or emergency care visits 11 , 12 , 13 , 14 that use hospital resources when they may already be near capacity.…”

Section: Introductionmentioning

confidence: 99%

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Screening for Health-Related Social Needs and Collaboration With External Partners Among US Hospitals

Ashe,

Baker,

Alvarado

et al. 2023

JAMA Netw Open

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ImportanceIn recent years, hospitals and health systems have reported increasing rates of screening for patients’ individual and community social needs, but few studies have explored the national landscape of screening and interventions directed at addressing health-related social needs (HRSNs) and social determinants of health (SDOH).ObjectiveTo evaluate the associations of hospital characteristics and area-level socioeconomic indicators to quantify the presence and intensity of hospitals’ screening practices, interventions, and collaborative external partnerships that seek to measure and ameliorate patients’ HRSNs and SDOH.Design, Setting, and ParticipantsThis cross-sectional study used national data from the American Hospital Association Annual Survey Database for fiscal year 2020. General-service, acute-care, nonfederal hospitals were included in the study’s final sample, representing nationally diverse hospital settings. Data were analyzed from July 2022 to February 2023.ExposuresOrganizational characteristics and area-level socioeconomic indicators.Main Outcomes and MeasuresThe outcomes of interest were hospital-reported patient screening of and strategies to address 8 HRSNs and 14 external partnership types to address SDOH. Composite scores for screening practices and external partnership types were calculated, and ordinary least-square regression analyses tested associations of organizational characteristics with outcome measures.ResultsOf 2858 US hospital respondents (response rate, 67.0%), most hospitals (79.2%; 95% CI, 77.7%-80.7%) reported screening patients for at least 1 HRSN, with food insecurity or hunger needs (66.1%; 95% CI, 64.3%-67.8%) and interpersonal violence (66.4%; 95% CI, 64.7%-68.1%) being the most commonly screened social needs. Most hospitals (79.4%; 95% CI, 66.3%-69.7%) reported having strategies and programs to address patients’ HRSNs; notably, most hospitals (52.8%; 95% CI, 51.0%-54.5%) had interventions for transportation barriers. Hospitals reported a mean of 4.03 (95% CI, 3.85-4.20) external partnership types to address SDOH and 5.69 (5.50-5.88) partnership types to address HRSNs, with local or state public health departments and health care practitioners outside of the health system being the most common. Hospitals with accountable care contracts (ACCs) and bundled payment programs (BPPs) reported higher screening practices (ACC: β = 1.03; SE = 0.13; BPP: β = 0.72; SE = 0.14), interventions (ACC: β = 1.45; SE = 0.12; BPP: β = 0.61; SE = 0.13), and external partnership types to address HRSNs (ACC: β = 2.07; SE = 0.23; BPP: β = 1.47; SE = 0.24) and SDOH (ACC: β = 2.64; SE = 0.20; BPP: β = 1.57; SE = 0.21). Compared with nonteaching, government-owned, and for-profit hospitals, teaching and nonprofit hospitals were also more likely to report more HRSN-directed activities. Patterns based on geographic and area-level socioeconomic indicators did not emerge.Conclusions and RelevanceThis cross-sectional study found that most US hospitals were screening patients for multiple HRSNs. Active participation in value-based care, teaching hospital status, and nonprofit status were the characteristics most consistently associated with greater overall screening activities and number of related partnership types. These results support previously posited associations about which types of hospitals were leading screening uptake and reinforce understanding of the role of hospital incentives in supporting health equity efforts.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Screening for Health-Related Social Needs and Collaboration With External Partners Among US Hospitals

Ashe,

Baker,

Alvarado

et al. 2023

JAMA Netw Open

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“…To better identify patients’ social factors, a greater number of healthcare settings are implementing systematic sociodemographic and social needs data collection across their entire patient population [ 8 ]. The systematic collection of sociodemographic and social needs information differs from the existing medical practice of taking the social history, which varies in quality and comprehensiveness, and is often not fully documented [ 9 , 10 ]. Further, there are multiple opportunities to utilize this data beyond immediate patient care, which is the purpose of taking a social history.…”

Section: Introductionmentioning

confidence: 99%

“…Despite the potential benefits, there is a considerable knowledge gap to understanding patients’ views on how sociodemographic and social needs data should be collected and used, particularly in inpatient internal medicine settings [ 8 , 10 , 17 ]. Inpatient internal medicine largely serves older adults with multiple complex chronic conditions who require a generalist approach to care [ 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

“Addressing the bigger picture”: A qualitative study of internal medicine patients’ perspectives on social needs data collection and use

et al. 2023

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Background There is increasing interest in collecting sociodemographic and social needs data in hospital settings to inform patient care and health equity. However, few studies have examined inpatients’ views on this data collection and what should be done to address social needs. This study describes internal medicine inpatients’ perspectives on the collection and use of sociodemographic and social needs information. Methods A qualitative interpretive description methodology was used. Semi-structured interviews were conducted with 18 patients admitted to a large academic hospital in Toronto, Canada. Participants were recruited using maximum variation sampling for diverse genders, races, and those with and without social needs. Interviews were coded using a predominantly inductive approach and a thematic analysis was conducted. Results Patients expressed that sociodemographic and social needs data collection is important to offer actionable solutions to address their needs. Patients described a gap between their ideal care which would attend to social needs, versus the reality that hospital-based teams are faced with competing priorities and pressures that make it unfeasible to provide such care. They also believed that this data collection could facilitate more holistic, integrated care. Patients conveyed a need to have a trusting and transparent relationship with their provider to alleviate concerns surrounding bias, discrimination, and confidentiality. Lastly, they indicated that sociodemographic and social needs data could be useful to inform care, support research to inspire social change, and assist them with navigating community resources or creating in-hospital programs to address unmet social needs. Conclusions While the collection of sociodemographic and social needs information in hospital settings is generally acceptable, there were varied views on whether hospital staff should intervene, as their priority is medical care. The results can inform the implementation of social data collection and interventions in hospital settings.

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Characterization of the Social Determinants of Health Faced By Hospitalized Patients

Cova,

Natchiappan,

Chi

et al. 2023

J GEN INTERN MED

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Collection and Use of Social Determinants of Health Data in Inpatient General Internal Medicine Wards: A Scoping Review

Cited by 6 publications

References 58 publications

Screening for Health-Related Social Needs and Collaboration With External Partners Among US Hospitals

Screening for Health-Related Social Needs and Collaboration With External Partners Among US Hospitals

“Addressing the bigger picture”: A qualitative study of internal medicine patients’ perspectives on social needs data collection and use

Characterization of the Social Determinants of Health Faced By Hospitalized Patients

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