Evaluation of the core 5 social determinants of health screening tool

• Published in: Public health Nursing Vol. 39; no. 2; pp. 438 - 445
• Main Authors: Bechtel, Nancie, Jones, Alexandria, Kue, Jennifer, Ford, Jodi L.
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.03.2022
• Subjects: access to health care; Electronic health records; Electronic medical records; Emergency medical care; Emergency medical services; Emergency Service, Hospital; emergency services; Evaluation; Food Insecurity; Food security; Health care; Health care access; Health care facilities; hospital; Housing; Humans; Medical screening; Patients; Primary care; Referral and Consultation; screening; Social Determinants of Health; access to health care; screening; social determinants of health; hospital; emergency services
• ISSN: 0737-1209; 1525-1446
• DOI: 10.1111/phn.12983

Objective This study evaluated the effects of a social determinants of health (SDH) screening tool and service referral on emergency department (ED) use among patients at a Federally Qualified Health Center primary care clinic. Study design Quasi‐experimental. Sample Three‐hundred and eleven English‐speaking patients 18 years and older. Measures The Core 5 SDH screening tool consists of five yes/no items assessing food, housing, utilities, transportation, and safety needs. The number of ED visits 3 months before and after the intervention were collected from electronic health records. Intervention The research team administered the Core 5 SDH screening tool and if desired, referred patients with an identified need for SDH services. Results Approximately 43% of patients reported a SDH need with food insecurity most prevalent (62.2%). The number of ED visits was significantly lower 3 months post‐intervention compared to 3 months before for the 125 participants who wanted and received the SDH service referral (IRR = 0.64, 95% CI = 0.41, 0.99) and for the 35 participants who reported receiving some/all of the needed services at the 2‐week follow‐up (IRR = 0.36, 95% CI = 0.17, 0.76). Conclusions Addressing patients’ SDH needs may reduce ED visits, lower healthcare costs, and ultimately, improve health.