Social risks and social needs in a health insurance exchange sample: a longitudinal evaluation of utilization.

Background: Health systems are increasingly attempting to intervene on social adversity as a strategy to improve health care outcomes. To inform health system efforts to screen for social adversity, we sought to explore the stability of social risk and interest in assistance over time and to evaluat...

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Publicado en:BMC Health Services Research Vol. 22; pp. 1 - 11
Autores principales: Lewis, Cara C., Jones, Salene M. W., Wellman, Robert, Sharp, Adam L., Gottlieb, Laura M., Banegas, Matthew P., De Marchis, Emilia, Steiner, John F.
Formato: research randomized controlled trial Journal Article
Publicado: BioMed Central 11/28/2022
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 11/28/2022
      vid: 22
      pid: 24147
      pub: BioMed Central
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        160457380
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        160457380
        10.1186/s12913-022-08740-6
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        160457380
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        atl: Social risks and social needs in a health insurance exchange sample: a longitudinal evaluation of utilization.
      aug:
        au:
          Lewis, Cara C.
          Jones, Salene M. W.
          Wellman, Robert
          Sharp, Adam L.
          Gottlieb, Laura M.
          Banegas, Matthew P.
          De Marchis, Emilia
          Steiner, John F.
        affil: Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave Suite 1600, 98101, Seattle, WA, USA
      sug:
        subj:
          Health Insurance Exchanges
          Public Assistance
          Patient Attitudes
          Critical Care
          Health Facilities
          Human
          Comparative Studies
          Multicenter Studies
          Randomized Controlled Trials
          Evaluation Research
          Funding Source
      ab: Background: Health systems are increasingly attempting to intervene on social adversity as a strategy to improve health care outcomes. To inform health system efforts to screen for social adversity, we sought to explore the stability of social risk and interest in assistance over time and to evaluate whether the social risk was associated with subsequent healthcare utilization.Methods: We surveyed Kaiser Permanente members receiving subsidies from the healthcare exchange in Southern California to assess their social risk and desire for assistance using the Accountable Health Communities instrument. A subset of initial respondents was randomized to be re-surveyed at either three or six months later.Results: A total of 228 participants completed the survey at both time points. Social risks were moderate to strongly stable across three and six months (Kappa range = .59-.89); however, social adversity profiles that included participants' desire for assistance were more labile (3-month Kappa = .52; 95% CI = .41-.64 & 6-month Kappa = .48; 95% CI = .36-.6). Only housing-related social risks were associated with an increase in acute care (emergency, urgent care) six months after initial screening; no other associations between social risk and utilization were observed.Conclusions: This study suggests that screening for social risk may be appropriate at intervals of six months, or perhaps longer, but that assessing desire for assistance may need to occur more frequently. Housing risks were associated with increases in acute care. Health systems may need to engage in screening and referral to resources to improve overall care and ultimately patient total health.
      pubtype: Academic Journal
      doctype:
        research
        randomized controlled trial
        Journal Article
      ougenre: Article
    language: English
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