Abstract
IntroductionSocial risks adversely affect health and are associated with increased healthcare utilization and costs. Emergency department (ED) patients have high rates of social risk; however, little is known about best practices for ED-based screening or linkage to community resources. We examined the perspectives of patients and community organizations regarding social risk screening and linkage from the ED.MethodsQualitative interviews were conducted with a purposive sample of ED patients and local community organization staff. Participants completed a brief demographic survey, health literacy assessment, and qualitative interview focused on barriers/facilitators to social risk screening in the ED, and ideas for screening and linkage interventions in the ED. Interviews were conducted in English or Spanish, recorded, transcribed, and coded. Themes were identified by consensus.ResultsWe conducted 22 interviews with 16 patients and six community organization staff. Three categories of themes emerged. The first related to the importance of social risk screening in the ED. The second category encompassed challenges regarding screening and linkage, including fear, mistrust, transmission of accurate information, and time/resource constraints. The third category included suggestions for improvement and program development. Patients had varied preferences for verbal vs electronic strategies for screening. Community organization staff emphasized resource scarcity and multimodal communication strategies.ConclusionThe development of flexible, multimodal, social risk screening tools, and the creation and maintenance of an accurate database of local resources, are strategies that may facilitate improved identification of social risk and successful linkage to available community resources.
Highlights
Social risks adversely affect health and are associated with increased healthcare utilization and costs
We examined the perspectives of patients and community organizations regarding social risk screening and linkage from the Emergency department (ED)
The first related to the importance of social risk screening in the ED
Summary
Social risks adversely affect health and are associated with increased healthcare utilization and costs. Emergency department (ED) patients have high rates of social risk; little is known about best practices for ED-based screening or linkage to community resources. We examined the perspectives of patients and community organizations regarding social risk screening and linkage from the ED. Emergency department (ED) patients have high rates of non-medical but health-related needs, including both food and housing instability.[1] A number of different terms have been used to describe these individual-level, adverse social determinants of health. Both the Accountable Health Communities project[7] and several Medicaid ACO demonstration studies are currently studying strategies for social risk screening and referral to community resources.[8,9]
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