Screening for Health-Related Social Needs of Emergency Department Patients - 18/12/20
, Krislyn M. Boggs, MPH a, Rebecca E. Cash, PhD, MPH a, Ramsey Herrington, MD b, Nathan W. Mick, MD c, Maia S. Rutman, MD d, Arjun K. Venkatesh, MD, MBA e, Christopher P. Zabbo, DO f, Ashley F. Sullivan, MS, MPH a, Kohei Hasegawa, MD, MPH a, Kori S. Zachrison, MD, MSc a, Carlos A. Camargo, MD, DrPH aAbstract |
Study objective |
There has been increasing attention to screening for health-related social needs. However, little is known about the screening practices of emergency departments (EDs). Within New England, we seek to identify the prevalence of ED screening for health-related social needs, understand the factors associated with screening, and understand how screening patterns for health-related social needs differ from those for violence, substance use, and mental health needs.
Methods |
We analyzed data from the 2018 National Emergency Department Inventory–New England survey, which was administered to all 194 New England EDs during 2019. We used descriptive statistics to compare ED characteristics by screening practices, and multivariable logistic regression models to identify factors associated with screening.
Results |
Among the 166 (86%) responding EDs, 64 (39%) reported screening for at least one health-related social need, 160 (96%) for violence (including intimate partner violence or other violent exposures), 148 (89%) for substance use disorder, and 159 (96%) for mental health needs. EDs reported a wide range of social work resources to address identified needs, with 155 (93%) reporting any social worker availability and 41 (27%) reporting continuous availability.
Conclusion |
New England EDs are screening for health-related social needs at a markedly lower rate than for violence, substance use, and mental health needs. EDs have relatively limited resources available to address health-related social needs. We encourage research on the development of scalable solutions for identifying and addressing health-related social needs in the ED.
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| Please see page 63 for the Editor’s Capsule Summary of this article. |
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| Supervising editor: Richelle J. Cooper, MD, MSHS. Specific detailed information about possible conflict of interest for individual editors is available at editors. |
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| Author contributions: MES-K conceived the current study and led development of the health-related social needs (HRSN) module of the 2019 NEDI-New England survey. MES-K wrote the initial draft of the manuscript. KMB developed the overall 2019 NEDI-New England survey, helped recruit the state coordinators, helped to secure Massachusetts ACEP endorsement of the survey, and coordinated all survey data collection and data management. REC completed the statistical analysis. WRH secured Vermont ACEP endorsement of the survey and assisted with data collection in Vermont. NWM secured Maine ACEP endorsement of the survey and assisted with data collection in Maine. MSR secured New Hampshire ACEP endorsement of the survey and assisted with data collection in New Hampshire. AKV secured Connecticut ACEP endorsement of the survey and assisted with data collection in Connecticut. PCZ secured Rhode Island ACEP endorsement of the survey and assisted with data collection in Rhode Island. AFS created the original NEDI-USA database. AFS, KH, and KSZ critically revised the 2019 NEDI-New England survey. CAC is PI of the ongoing NEDI-USA project and designed and developed the 2019 NEDI-New England survey. CAC helped to recruit the state coordinators, helped to secure Massachusetts ACEP endorsement of the survey, and assisted with data collection in Massachusetts. CAC provided overall supervision of the study. KMB, REC, WRH, NWM, MSR, AKV, PCZ, AFS, KH, KSZ, and CA critically revised the paper. All authors reviewed and approved the submitted manuscript. MES-K takes responsibility of the paper as a whole. |
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| All authors attest to meeting the four ICMJE.org authorship criteria: (1) Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND (2) Drafting the work or revising it critically for important intellectual content; AND (3) Final approval of the version to be published; AND (4) Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. |
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| Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org). The authors have stated that no such relationships exist. This study was supported by a grant from R Baby Foundation (New York, NY). Dr. Samuels-Kalow is supported by the Harvard Catalyst/ The Harvard Clinical and Translational Science Center (National Center for Advancing Translational Sciences, National Institutes of Health award UL 1TR002541) and financial contributions from Harvard University and its affiliated academic health care centers. |
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| The content is solely the responsibility of the authors and does not necessarily represent the official views of Harvard Catalyst, Harvard University and its affiliated academic health care centers, or the National Institutes of Health. |
Vol 77 - N° 1
P. 62-68 - janvier 2021 Retour au numéro
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