Assessment of structured data elements for social risk factors

Vest, Joshua R.; Adler‐Milstein, Julia; Gottlieb, Laura M.; Bian, Jiang; Campion, Thomas R.; Cohen, Genna R.; Donnelly, Nathan; Harper, Jeremy; Huerta, Timothy R.; Kansky, John P; Kharrazi, Hadi; Khurshid, Anjum; Kooreman, Harold E; McDonnell, Cara; Overhage, J. Marc; Pantell, Matthew S.; Parisi, Wendy; Shenkman, Louis; Tierney, William M.; Wiehe, Sarah E.; Harle, Christopher A.

doi:10.37765/ajmc.2022.88816

Cited by 10 publications

(5 citation statements)

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“…Documentation of social factors in the medical records was generally consistent in terms of frequency and variability with the findings by Eder, where food insecurity, financial strain, and housing instability were recorded at frequencies of 63%, 49%, and 59%, respectively [29]. Documentation helps in constructing prediction models and identifying patients in need of social services [30]. It also facilitates the proper transition of patients across different points of care, and the information can be used to ensure consistency in follow up hence proper continuity of care.…”

Section: Discussionsupporting

confidence: 73%

“…Tools are crucial for the proper identification and documentation of social factors, but the lack of properly validated tools has been cited as a challenge. The importance of tools on the extent of documentation has been emphasized, including the use of diagnostic codes such as the International Classification of Diseases [30]. Differences in the documentation for the four medical conditions can be attributed to variations in clinical guidelines.…”

Section: Discussionmentioning

confidence: 99%

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Extent of Integration of Social Determinants of Health in Clinical Practice in Hospitals in Uganda

Emmanuel¹

2023

TIJPH

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The study determined the extent to which health workers in hospitals in Uganda integrate social determinants into clinical practice. This will provide a baseline for improvement interventions and act as a starting point for elucidating the factors influencing the integration of social determinants into clinical practice. This was a multi-method cross-sectional study conducted at 12 hospitals in Uganda. Data was collected between September and November 2021 involving 1042 health workers, 21 key informants, 2119 medical records, and six focus groups. The extent of integration was measured using an eight-item Likert scale for health workers (Cronbach’s alpha of 0.794, inter-item correlation 0.15 to 0.5;) 24-item Likert scale for key informants (Cronbach’s alpha was 0.973, inter-item correlation 0.18 to 0.936), and medical records. The study was approved by the research and ethics committee of Makerere University School of Health Sciences and by the Texila American University Faculty and registered by the National Council of Science and Technology. The aggregate extent of integration was 66%, computed as the average health workers score (66%), key informants score (65%), and medical records score (66%). There were variations across hospitals and social demographics of health workers. The extent of integration of social determinants into clinical practice was successfully determined. Further investigations are required to explain the variations across hospitals. The study did not take into consideration carry-over effects from health workers working in non-hospital healthcare settings. Keywords: Social determinants; Clinical practice; Integration; Factors; Hospitals; Uganda.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Extent of Integration of Social Determinants of Health in Clinical Practice in Hospitals in Uganda

Emmanuel¹

2023

TIJPH

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“…Additionally, no agreed-upon measurement frequency really exists. Further, while clinical information systems like EHRs include data on many HRSNs 30 , these systems/processes of care delivery were not designed to systematically collect HRSN data. Therefore, any effort to measure the HRSNs needed for a risk score will require multiple modalities, e.g., surveys, natural language processing, or inclusion of social service referral history.…”

Section: Discussionmentioning

confidence: 99%

“…For physicians, the primary qualification was direct patient care experience in screening or asking about patients’ health-related social needs. Following our previously successful approach 30 , we emailed authors of research studies on HRSNs or the role of HRSNs in medical education and practice. We were attentive to geographical diversity (CA, DC, FL, IL, IN, MA, MD, NM, NY, OH, PA) and practice setting (e.g., emergency department and primary care).…”

Section: Methodsmentioning

confidence: 99%

Expert panel identified health-related social needs and methodological considerations for a polysocial risk score

Vest,

McNamee,

Musey

2023

Preprint

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Objectives: A polysocial risk score, which summaries multiple different health-related social needs (HRSNs) into a single likelihood of risk, could support more effective patient and population health management. Nevertheless, developing a polysocial risk score faces uncertainties and challenges due the HRSNs' differing etiologies and interventions, cooccurrence, and variation in information availability. Methods: A 3-round Delphi technique to elicit expert opinion and develop a preliminary polysocial risk score approach. Expert panel members included physicians (n=8), social service professionals & staff (n=9), and patients (n=6). For physicians, the primary qualification was direct patient care experience in screening or asking about patients' health-related social needs. Social service professionals & staff had titles of: nurse, patient care assistant, patient advocate, community health worker, director of community services. Round 1 obtained an initial importance of HRSNs on general health & well-being and total healthcare cost. Panelists also suggested additional HRSNs Responses served as discussion points for Round 2. Five focus groups explored how HRSNs should be ranked; additional HRSNs to include; timing of measurements; management of non-response and missing data; and concerns about bias and equity. We analyzed the transcripts using a consensus coding approach. Panelists then completed a follow-up survey. Results: Panelists identified 17 HRSNs relevant to health and well-being for inclusion in a polysocial risk score. Methodology concerns ranging from the sources and quality of data, non-random missing information, data timeliness, and the need for different risk scores by population. Panelist also raised concerns about potential bias and missaplication of a polysocial risk score. Conclusion: A polysocial risk score is a potentially useful addition to the growing methodologies to better understand and address HRSNs. Nevertheless, development is potentially complicated and fraught with challenges.

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“…Social risk factors affect morbidity, mortality, and utilization of healthcare services in a variety of ways [3,10,11]. At the preclinical level, social determinants influence patients' perception of symptoms, treatment-seeking behavior, and access to healthcare facilities.…”

Section: Introductionmentioning

confidence: 99%

Factors Influencing Integration of Social Determinants of Health into Clinical Practice in Hospitals in Uganda

Emmanuel¹

2023

TIJPH

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The overall objective of this study was to assess the factors influencing the extent of integration of social determinants of health (SDH) into clinical practice in hospitals in Uganda. This was cross-sectional. Data was collected from 1042 health workers using a self-administered questionnaire. The factors influencing integration were elucidated using multiple regression modeling. The final model of the influencing factors contained the factor domains health worker confidence, hospital environment, health worker attitude, adoption level for strategies of integration, disease characteristics, and accreditation to the Nurses and Midwives Council. The study successfully elucidated the model for factors influencing the integration of social determinants into clinical practice. The findings have educational, practice, administrative, and policy implications. The multi-method approach was used to limit social desirability bias among health workers; however, the study did not adjust for carry-over effects arising from health workers who were also practicing in private clinics and medical centres. Keywords: Clinical practice; Factors, Integration; Social determinants.

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Assessment of structured data elements for social risk factors

Cited by 10 publications

References 0 publications

Extent of Integration of Social Determinants of Health in Clinical Practice in Hospitals in Uganda

Extent of Integration of Social Determinants of Health in Clinical Practice in Hospitals in Uganda

Expert panel identified health-related social needs and methodological considerations for a polysocial risk score

Factors Influencing Integration of Social Determinants of Health into Clinical Practice in Hospitals in Uganda

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