Date of Award

1-1-2023

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Karen Wang

Abstract

Social needs screenings within healthcare systems have grown more common with increasing discourse around the contribution of systemic determinants to health outcomes. These screenings have been used to describe the prevalence of social needs within communities but have not been evaluated for the impact that they and the interventions to which they are attached may have on health outcomes. Here we evaluate social needs screenings and their potential impact on patient health at a federally qualified health center in New Haven, Connecticut. We describe the baseline needs at the facility, evaluate change in reported social needs among patients undergoing screening, and factors associated with decreases in reported social needs. Our analysis uses two samples, to reflect broad health data and emergency room utilization among patients screened for social needs at our study site. For both samples, the socio-demographic, clinical characteristics of those who screened positive and those who screened negative was compared using chi square and t-tests. Multivariable logistic regression was used to determine the socio-demographic factors associated with reported social needs at the initial visit, and social need persistence at the last registered visit. Change in emergency room utilization pre- and post-social needs screening was compared using a paired t-test. Within our first sample, the majority of the sample screened positive for at least one social need. The most commonly reported social needs were financial stain, food insecurity, and employment. At the index visit, those screening positive for social needs were younger, more likely to use English as a primary language, and less likely to be on Commercial or Medicare insurance. At the final screening, 16.4% of those who screened positive at their initial assessment reported no social needs. Thirty-six percent of those with no reported social needs at the index visit now reported at least one new need. Screening positive for any need at the last visit was only associated with younger age. For sample two, the majority also screened positive for at least one need with the most common needs being financial strain, food, and living situation. The majority of the sample screening positive for social needs only had 1 or 2 social needs identified. Factors associated with screening positive were younger age, English as the preferred language, and a medical history without diabetes and stroke history. The mean number of emergency room visits before initial and after final screenings were 1.18 and 0.98, respectively, a significant difference. Overall, our results suggest that the integration of social needs screening with a referral to care coordinator can identify social needs and may alleviate patients’ social needs.

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This is an Open Access Thesis.

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