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Implementing Health Related Social Needs Screening in an Outpatient Clinic.

Publication ,  Journal Article
Nohria, R; Xiao, N; Guardado, R; Drainoni, M-L; Smith, C; Nokes, K; Byhoff, E
Published in: J Prim Care Community Health
2022

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: BHC 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.

Duke Scholars

Published In

J Prim Care Community Health

DOI

EISSN

2150-1327

Publication Date

2022

Volume

13

Start / End Page

21501319221118809

Location

United States

Related Subject Headings

  • United States
  • Medicare
  • Medicaid
  • Mass Screening
  • Humans
  • Cross-Sectional Studies
  • Ambulatory Care Facilities
  • Aged
  • 4206 Public health
  • 4205 Nursing
 

Citation

APA
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ICMJE
MLA
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Nohria, R., Xiao, N., Guardado, R., Drainoni, M.-L., Smith, C., Nokes, K., & Byhoff, E. (2022). Implementing Health Related Social Needs Screening in an Outpatient Clinic. J Prim Care Community Health, 13, 21501319221118810. https://doi.org/10.1177/21501319221118809
Nohria, Raman, Nan Xiao, Rubeen Guardado, Mari-Lynn Drainoni, Cara Smith, Keith Nokes, and Elena Byhoff. “Implementing Health Related Social Needs Screening in an Outpatient Clinic.J Prim Care Community Health 13 (2022): 21501319221118810. https://doi.org/10.1177/21501319221118809.
Nohria R, Xiao N, Guardado R, Drainoni M-L, Smith C, Nokes K, et al. Implementing Health Related Social Needs Screening in an Outpatient Clinic. J Prim Care Community Health. 2022;13:21501319221118810.
Nohria, Raman, et al. “Implementing Health Related Social Needs Screening in an Outpatient Clinic.J Prim Care Community Health, vol. 13, 2022, p. 21501319221118810. Pubmed, doi:10.1177/21501319221118809.
Nohria R, Xiao N, Guardado R, Drainoni M-L, Smith C, Nokes K, Byhoff E. Implementing Health Related Social Needs Screening in an Outpatient Clinic. J Prim Care Community Health. 2022;13:21501319221118810.
Journal cover image

Published In

J Prim Care Community Health

DOI

EISSN

2150-1327

Publication Date

2022

Volume

13

Start / End Page

21501319221118809

Location

United States

Related Subject Headings

  • United States
  • Medicare
  • Medicaid
  • Mass Screening
  • Humans
  • Cross-Sectional Studies
  • Ambulatory Care Facilities
  • Aged
  • 4206 Public health
  • 4205 Nursing