IMPORTANCE Social needs, including food, housing, utilities, transportation, and experience with interpersonal violence, are linked to health outcomes. Identifying patients with unmet social needs is a necessary first step to addressing these needs, yet little is known about the prevalence of screening. OBJECTIVE To characterize screening for social needs by physician practices and hospitals. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional survey analyses of responses by physician practices and hospitals to the 2017-2018 National Survey of Healthcare Organizations and Systems.

Addressing non-medical needs is critical to advance population health, improve quality of care, and lower the costs of care. Accountable care organizations (ACOs) may be more likely to address these needs. We used qualitative interviews to examine how ACOs address non-medical patient needs. We developed a typology of medical and social services among ACOs that disentangles services and organizational integration. ACOs commonly addressed housing, transportation, and food insecurity needs. ACOs identified needs through processes as part of the primary care visit or existing care management programs. ACO approaches to meeting patients’ non-medical needs were characterized as either individualized solutions, developed on a patient-by-patient basis; or targeted approaches, programs developed to address specific needs. As policymakers continue to invest in programs to spur organizations to meet a broader spectrum of patients’ needs, these findings offer insights on how health care organizations integrate with non-medical organizations.

Objective: Examine how patient-clinician information engagement (PCIE) may operate through feeling informed to influence patients' treatment decision satisfaction (TDS). Methods:Randomly drawn sample (N=2013) from Pennsylvania Cancer Registry, comprised of breast, prostate and colon cancer patients completed mail surveys in Fall of 2006 (response rate = 64%) and Fall of 2007. Of 2013 baseline respondents, 85% agreed to participate in follow-up survey (N=1703). Of those who agreed, 76% (N=1293) completed follow-up surveys. The sample was split between males and females. The majority of participants were White, over the age of 50, married, and with a high school degree. Most reported having been diagnosed with in situ and local cancer.Results: PCIE was related to concurrent TDS (β=.06) and feeling informed (β=.15), after confounder adjustments. A mediation analysis was consistent with PCIE affecting TDS through feeling informed. Baseline PCIE predicted feeling informed (β=.04) measured one year later, after adjustments for baseline feeling informed and other confounders. Feeling informed was related to concurrent TDS (β=.35) after confounder adjustment and follow-up TDS (β=.13) after baseline TDS and confounder adjustment. Conclusion: Results suggest PCIE affects TDS in part through patients' feeling informed.Practice Implications: PCIE may be important in determining patients' level of feeling informed and TDS. Corresponding author at: Annenberg School for Communication, Philadelphia, PA, 19104, USA. lmartinez@asc.upenn.edu.. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access BackgroundWe know that many newly-diagnosed cancer patients are heavily involved with information gathering both from their physicians and from other sources [1,2]. We also know that treatment satisfaction is related to treatment adherence and good health outcomes [3]. However, we do not know whether and how information gathering from and exchanged with physicians is related to treatment satisfaction. Are those who are highly engaged in patientphysician communication more likely to be satisfied with their treatment decision because they feel well informed? Or are they less likely to be satisfied because their information engagement with information from their physician raises uncertainties or undermines their confidence in their treating physicians?Patient satisfaction with health care services is associated with improved health outcomes and is a predictor of important health behaviors, such as adherence with prescribed treatment plans and regimens [4][5][6]. More specifically,...

BackgroundIn recent years, response rates to telephone surveys have declined. Online surveys may miss many older and poorer adults. Mailed surveys may have promise in securing higher response rates.MethodsIn a pilot study, 1200 breast, prostate and colon patients, randomly selected from the Pennsylvania Cancer Registry, were sent surveys in the mail. Incentive amount ($3 vs. $5) and length of the survey (10 pages vs. 16 pages) were randomly assigned.ResultsOverall, there was a high response rate (AAPOR RR4 = 64%). Neither the amount of the incentive, nor the length of the survey affected the response rate significantly. Colon cancer surveys were returned at a significantly lower rate (RR4 = 54%), than breast or prostate surveys (RR4 = 71%, and RR4 = 67%, respectively; p < .001 for both comparisons). There were no significant interactions among cancer type, length of survey and incentive amount in their effects on response likelihood.ConclusionMailed surveys may provide a suitable alternative option for survey-based research with cancer patients.