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{ "pk": 17543, "title": "Social Determinants of Health Screening at an Urban Emergency Department Urgent Care During COVID-19", "subtitle": null, "abstract": "Introduction:\n Social determinants of health (SDoH) impact patients’ health outcomes, yet screening methods in emergency departments (ED) are not consistent or standardized. The SDoH-related health disparities may have widened during the coronavirus 2019 (COVID-19) pandemic, especially among patients who primarily receive their medical care in EDs. We sought to identify SDoH among ED urgent care patients during the COVID-19 pandemic at an urban safety-net hospital, assess the impact of the pandemic on their SDoH, study the feasibility of SDoH screening and resource referrals, and identify preferred methods of resource referrals and barriers to accessing resources.\nMethods:\n Research assistants screened ED urgent care patients using a validated SDoH screener, inquiring about the impact of COVID-19 on their SDoH. A printed resource guide was provided. Two weeks later, a follow-up telephone survey assessed for barriers to resource connection and patients’ preferred methods for resource referrals. This study was deemed exempt by our institutionalreview board.\nResults:\n Of the 418 patients presented with a screener, 414 (99.0%) patients completed the screening. Of those screened, 296 (71.5%) reported at least one adverse SDoH, most commonly education (38.7%), food insecurity (35.3%), and employment (31.0%). Housing insecurity was reported by 21.0%. Over half of patients (57.0%) endorsed COVID-19 affecting their SDoH. During follow-up, 156 of 234 (67%) attempted calls were successful and 36/156 (23.1%) reported attempting to connect with a resource, with most attempts made for stable housing (11.0%) and food (7.7%). Reasons for not contacting the provided resources included lack of time (37.8%) and forgetting to do so (26.3%). Patients preferred resource guides to be printed (34.0%) and sent via text message to their mobile devices (25.6%).\nConclusion:\n Many urgent care patients of this urban ED reported at least one adverse SDoH, the majority of which were exacerbated by the COVID-19 pandemic. This finding further emphasizes the need to allocate more resources to standardize and expand SDoH screening in EDs. Additionally, hospitals should increase availability of printed or electronic SDoH resource guides, resource navigators, and interpreters both during and after ED visits.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "social determinants of health" }, { "word": "SDOH" }, { "word": "Screening social determinants of health" }, { "word": "Screening SDOH" }, { "word": "social emergency medicine" }, { "word": "Social EM" }, { "word": "COVID-19" } ], "section": "Health Equity", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/6jt4h6zp", "frozenauthors": [ { "first_name": "Haeyeon", "middle_name": "", "last_name": "Hong", "name_suffix": "", "institution": "Boston Medical Center, Department of Emergency Medicine, Boston, Massachusetts; Boston University School of Medicine, Department of Emergency Medicine, Boston, Massachusetts", "department": "None" }, { "first_name": "Kalpana", "middle_name": "Narayan", "last_name": "Shankar", "name_suffix": "", "institution": "Boston Medical Center, Department of Emergency Medicine, Boston, Massachusetts; Boston University School of Medicine, Department of Emergency Medicine, Boston, Massachusetts; Brigham and Women’s Hospital, Department of Emergency Medicine, Boston, Massachusetts", "department": "None" }, { "first_name": "Andrew", "middle_name": "", "last_name": "Thompson", "name_suffix": "", "institution": "Boston Medical Center, Department of Emergency Medicine, Boston, Massachusetts", "department": "None" }, { "first_name": "Pablo", "middle_name": "Buitron", "last_name": "De La Vega", "name_suffix": "", "institution": "Boston University School of Medicine, Department of Internal Medicine, Boston, Massachusetts", "department": "None" }, { "first_name": "Rashmi", "middle_name": "", "last_name": "Koul", "name_suffix": "", "institution": "Boston Medical Center, Department of Emergency Medicine, Boston, Massachusetts", "department": "None" }, { "first_name": "Emily", "middle_name": "Cleveland", "last_name": "Manchanda", "name_suffix": "", "institution": "Boston Medical Center, Department of Emergency Medicine, Boston, Massachusetts; Boston University School of Medicine, Department of Emergency Medicine, Boston, Massachusetts; American Medical Association, Center for Health Equity, Boston, Massachusetts", "department": "None" }, { "first_name": "Sorraya", "middle_name": "", "last_name": "Jaiprasert", "name_suffix": "", "institution": "Boston Medical Center, Department of Emergency Medicine, Boston, Massachusetts", "department": "None" }, { "first_name": "Samantha", "middle_name": "", "last_name": "Roberts", "name_suffix": "", "institution": "Boston Medical Center, Department of Emergency Medicine, Boston, Massachusetts", "department": "None" }, { "first_name": "Tyler", "middle_name": "", "last_name": "Pina", "name_suffix": "", "institution": "Boston Medical Center, Department of Emergency Medicine, Boston, Massachusetts", "department": "None" }, { "first_name": "Emily", "middle_name": "", "last_name": "Anderson", "name_suffix": "", "institution": "Boston University School of Medicine, Boston, Massachusetts", "department": "None" }, { "first_name": "Jessica", "middle_name": "", "last_name": "Lin", "name_suffix": "", "institution": "Boston University School of Medicine, Boston, Massachusetts", "department": "None" }, { "first_name": "Gabrielle", "middle_name": "A.", "last_name": "Jacquet", "name_suffix": "", "institution": "Boston Medical Center, Department of Emergency Medicine, Boston, Massachusetts; Boston University School of Medicine, Department of Emergency Medicine, Boston, Massachusetts", "department": "None" } ], "date_submitted": "2022-09-30T17:11:15-04:00", "date_accepted": "2022-09-30T17:11:15-04:00", "date_published": "2023-07-17T09:53:53-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/17543/galley/8945/download/" } ] }