Screening and Referral Care Delivery Services and Unmet Health-Related Social Needs: A Systematic Review

Abstract

Introduction Unmet health-related social needs contribute to high patient morbidity and poor population health. A potential solution to improve population health includes the adoption of care delivery models that alleviate unmet needs through screening, referral, and tracking of patients in health care settings, yet the overall impact of such models has remained unexplored. This review addresses an existing gap in the literature regarding the effectiveness of these models and assesses their overall impact on outcomes related to experience of care, population health, and costs. Methods In March 2020, we searched for peer-reviewed articles published in PubMed over the past 10 years. Studies were included if they 1) used a screening tool for identifying unmet health-related social needs in a health care setting, 2) referred patients with positive screens to appropriate resources for addressing identified unmet health-related social needs, and 3) reported any outcomes related to patient experience of care, population health, or cost. Results Of 1,821 articles identified, 35 met the inclusion criteria. All but 1 study demonstrated a tendency toward high risk of bias. Improved outcomes related to experience of care (eg, change in social needs, patient satisfaction, n = 34), population health (eg, diet quality, blood cholesterol levels, n = 7), and cost (eg, program costs, cost-effectiveness, n = 3) were reported. In some studies (n = 5), improved outcomes were found among participants who received direct referrals or additional assistance with indirect referrals compared with those who received indirect referrals only. Conclusion Effective collaborations between health care organizations and community-based organizations are essential to facilitate necessary patient connection to resources for addressing their unmet needs. Although evidence indicated a positive influence of screening and referral programs on outcomes related to experience of care and population health, no definitive conclusions can be made on overall impact because of the potentially high risk of bias in the included studies.

Evaluating the complex association between Social Vulnerability Index and trauma mortality

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Predictors of Counseling Participation Among Low-Income People Offered an Integrated Intervention Targeting Financial Distress and Tobacco Use

“…On-site services fully integrated into health programs limit the time and financial burdens on patients, and also offer increased ease of data sharing between health and financial programs. Prior research has also found that the degree of uptake of programs devoted to screening and referring patients to social needs resources can vary by the referral approach (passive versus direct or warm hand-off), the accessibility of referral sites, and the intensity of time and labor required by patients to access resources (Ruiz Escobar et al, 2021 ; Sanderson et al, 2021 ). The fact that the on-site money management coaching provided by the current program’s smoking cessation counselors was the most frequently received intervention component in the current study, while the referral to an FEC was the least frequently received component, is consistent with this prior research.…”