Impact of Social Needs Navigation on Utilization Among High Utilizers in a Large Integrated Health System: a Quasi-experimental Study

Schickedanz, Adam; Sharp, Adam L.; Hu, Yi R; Shah, Nirav R.; Adams, John; Francis, Damon; Rogers, Artair

doi:10.1007/s11606-019-05123-2

Cited by 96 publications

(114 citation statements)

References 27 publications

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“…Among those with negative screening results for all 5 social risks, The proportion of patients interested in social risk assistance has varied in previous studies. 6,7,[9][10][11][12][13][14][15][16][17][18]20 In the present study, we found that 53.3% of those with positive screening results were interested in receiving assistance, although results varied by study site. Our finding that 8.6% of participants were interested in assistance despite receiving negative screening results is consistent with previous research.…”

Section: Discussionmentioning

confidence: 43%

Assessment of Social Risk Factors and Interest in Receiving Health Care–Based Social Assistance Among Adult Patients and Adult Caregivers of Pediatric Patients

et al. 2020

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IMPORTANCE Health care organizations are increasingly incorporating social risk screening into patient care. Studies have reported wide variations in patients' interest in receiving health carebased assistance for identified social risks. However, no study to date has examined the factors associated with patients' interest in receiving assistance, including whether interest in receiving assistance varies based on specific patient demographic characteristics. Targeted research on this topic could improve the success of health care-based programs that offer social care services. OBJECTIVE To identify participant characteristics associated with interest in receiving health carebased social risk assistance. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study was conducted in 7 primary care clinics and 4 emergency departments in 9 US states between July 2, 2018, and February 13, 2019. A convenience sample of adult patients and adult caregivers of pediatric patients completed a screening survey that measured social risk factors and participants' interest in receiving assistance for identified social risks. Participants were randomly selected to receive 1 of 2 versions of the survey, which differed based on the order in which questions about social risks and interest in receiving assistance were presented. Multivariable logistic regression analyses were used to evaluate the associations between covariates and participants' interest in receiving assistance, stratified by social risk screening results. Data were analyzed from September 8, 2019, to July 30, 2020. EXPOSURES Social risk screening questions assessed risk factors comprising housing, food, transportation, utilities, and exposure to interpersonal violence. Additional questions assessed participants' interest in receiving assistance and their perspectives on health care-based social risk screening. MAIN OUTCOMES AND MEASURES Participant interest in receiving health care-based social risk assistance. RESULTS A total of 1021 adult participants with complete survey responses were included in the analysis. Of those, 709 of 1004 participants (70.6%) were female, and 544 of 1007 participants (54.0%) were aged 18 to 44 years. Overall, 353 of 662 participants (53.3%) with positive screening results for 1 or more social risk factors were interested in receiving assistance, whereas 31 of 359 participants (8.6%) with negative screening results for all social risks were interested in receiving assistance. Participants with positive screening results for 1 or more social risk factors had a higher likelihood of being interested in receiving assistance if they answered the question about interest in receiving assistance before they answered the questions about social risk factors (adjusted odds ratio [aOR], 1.48; 95% CI, 1.05-2.07), had positive screening results for a higher number of social risk factors (aOR, 2.40; 95% CI, 1.68-3.42), reported lower household income levels (aOR, 7.78; 95% CI, (continued) Key Points Question Are specific social risk factors associated...

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Section: Discussionmentioning

confidence: 43%

Assessment of Social Risk Factors and Interest in Receiving Health Care–Based Social Assistance Among Adult Patients and Adult Caregivers of Pediatric Patients

et al. 2020

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“…Interventions that can increase the likelihood of obtaining resources have been the focus of previous publications, though few have examined the impacts on specific subpopulations. 5,7,14,[19][20][21][23][24][25][26][39][40][41][42][43] Positive prior experiences do influence patient perspectives of health care-based social care activities. 17,18 But interest in assistance-and the impact of related interventions-also may be influenced by cultural and demographic characteristics (eg, perceived stigma associated with receipt of benefits, documentation status, or preferred language).…”

Section: Safety Concernmentioning

confidence: 99%

“…[15][16][17][18] A more complex finding from these programs, however, is that many patients who screen positive for social risks subsequently decline assistance to address those risks from health care team members. [5][6][7]14,[19][20][21][22][23][24][25][26] In a recent community health center study, for instance, over 90% of patients screened positive for at least one social risk factor, but only about 20% wanted assistance from health center staff. 7 In other studies, differences are less dramatic, but the theme has surfaced across multiple settings.…”

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confidence: 99%

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Do Patients Want Help Addressing Social Risks?

2020

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Evaluations of health care-based screening programs for social risks often report that a relatively small proportion of patients screening positive for social risk factors are interested in receiving assistance from their health care teams to address them. The relatively low number of patients who desire assistance is relevant to the growing number of initiatives in US health care settings designed to collect data on and address patients' social risks. We highlight multiple studies that have found differences between positive risks screens and desire for assistance. We explore possible explanations for those differences-focusing on the fallibility of screening tools as well as patient preferences, priorities, and lived experiences-and the potential implications for health equity.

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“…Notably, a recent large study of over 34,000 patients found that 53% screened positive, but only 10% were able to connect with resources to address their needs. 10 Another study found that only 19% of patients with a health-related social need reported in the electronic health record had a documented referral placed. 20 These studies further underscore the importance of developing interventions that not only identify social risk, but successfully link patients to adequate resources in their communities.…”

Section: On Demand Information and Navigationmentioning

confidence: 99%

Patient and Community Organization Perspectives on Accessing Social Resources from the Emergency Department: A Qualitative Study

Samuels‐Kalow

Molina

Ciccolo

et al. 2020

WestJEM

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Introduction: Social risks adversely affect health and are associated with increased healthcare utilization and costs. Emergency department (ED) patients have high rates of social risk; however, little is known about best practices for ED-based screening or linkage to community resources. We examined the perspectives of patients and community organizations regarding social risk screening and linkage from the ED. Methods: Qualitative interviews were conducted with a purposive sample of ED patients and local community organization staff. Participants completed a brief demographic survey, health literacy assessment, and qualitative interview focused on barriers/facilitators to social risk screening in the ED, and ideas for screening and linkage interventions in the ED. Interviews were conducted in English or Spanish, recorded, transcribed, and coded. Themes were identified by consensus. Results: We conducted 22 interviews with 16 patients and six community organization staff. Three categories of themes emerged. The first related to the importance of social risk screening in the ED. The second category encompassed challenges regarding screening and linkage, including fear, mistrust, transmission of accurate information, and time/resource constraints. The third category included suggestions for improvement and program development. Patients had varied preferences for verbal vs electronic strategies for screening. Community organization staff emphasized resource scarcity and multimodal communication strategies. Conclusion: The development of flexible, multimodal, social risk screening tools, and the creation and maintenance of an accurate database of local resources, are strategies that may facilitate improved identification of social risk and successful linkage to available community resources. [West J Emerg Med. 2020;21(4)964-973.] been used to describe these individual-level, adverse social determinants of health. For the purposes of this paper, we will term these "specific adverse social conditions that are associated with poor health" as social risk. 2 Social risks are

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Impact of Social Needs Navigation on Utilization Among High Utilizers in a Large Integrated Health System: a Quasi-experimental Study

Cited by 96 publications

References 27 publications

Assessment of Social Risk Factors and Interest in Receiving Health Care–Based Social Assistance Among Adult Patients and Adult Caregivers of Pediatric Patients

Assessment of Social Risk Factors and Interest in Receiving Health Care–Based Social Assistance Among Adult Patients and Adult Caregivers of Pediatric Patients

Do Patients Want Help Addressing Social Risks?

Patient and Community Organization Perspectives on Accessing Social Resources from the Emergency Department: A Qualitative Study

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