Correspondence| Volume 36, ISSUE 11, P2108-2109, November 01, 2018

Are acute care settings amenable to addressing patient social needs: A sub-group analysis

Published:March 15, 2018DOI:https://doi.org/10.1016/j.ajem.2018.03.034
Are acute care settings amenable to addressing patient social needs: A sub-group analysis
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      Based on a strong body of evidence linking socioeconomic status and health, interest in patients' social and economic needs is rapidly expanding [
      • American Academy of Pediatrics Council On Community
      Poverty and child health in the United States.
      Pediatrics. 2016; 137https://doi.org/10.1542/peds.2016-0339
      ,
      • APA Task Force on Childhood Poverty
      A strategic road-map: committed to bringing the voice of pediatricians to the most important problem facing children in the US today.
      http://www.ambpeds.org/public_policy/pdf/APA_Task_Force_Strategic_Road_Mapver3.pdf
      Date: 2003
      Date accessed: April 7, 2017
      ,
      • American Academy of Pediatrics Medical Home Initiatives for Children with Special Needs Project Advisory Committee
      The medical home.
      Pediatrics. 2002; 110: 184-186
      ,
      • American Academy on Pediatrics Committee on Community Health Services
      The pediatrician's role in community pediatrics.
      Pediatrics. 2005; 115: 1092-1094https://doi.org/10.1542/peds.2004-2680
      ,
      • Baer T.E.
      • Gottlieb L.
      • Sandel M.
      Addressing social determinants of health in the adolescent medical home.
      Curr Opin Pediatr. 2013; 25: 447-453https://doi.org/10.1097/MOP.0b013e32836280ae
      ,
      • Chung E.K.
      • Siegel B.S.
      • Garg A.
      • Conroy K.
      • Gross R.S.
      • Long D.A.
      • et al.
      Screening for social determinants of health among children and families living in poverty: a guide for clinicians.
      Curr Probl Pediatr Adolesc Health Care. 2016; 46: 135-153https://doi.org/10.1016/j.cppeds.2016.02.004
      ,
      • Fieldston E.S.
      • Zaniletti I.
      • Hall M.
      • Colvin J.D.
      • Gottlieb L.
      • Macy M.L.
      • et al.
      Community household income and resource utilization for common inpatient pediatric conditions.
      Pediatrics. 2013; 132: e1592-601https://doi.org/10.1542/peds.2013-0619
      ,
      • Colvin J.D.
      • Zaniletti I.
      • Fieldston E.S.
      • Gottlieb L.M.
      • Raphael J.L.
      • Hall M.
      • et al.
      Socioeconomic status and in-hospital pediatric mortality.
      Pediatrics. 2013; 131: e90-e182https://doi.org/10.1542/peds.2012-1215
      ]. This has seeded new research on the feasibility and impact of incorporating interventions that address patients' social needs—like early literacy initiatives, community linkage programs, and legal services—into routine health care delivery [
      • Fleegler E.W.
      • Lieu T.A.
      • Wise P.H.
      • Muret-Wagstaff S.
      Families' health-related social problems and missed referral opportunities.
      Pediatrics. 2007; 119: e1332-41https://doi.org/10.1542/peds.2006-1505
      ,
      • Garg A.
      • Toy S.
      • Tripodis Y.
      • Silverstein M.
      • Freeman E.
      Addressing social determinants of health at well child care visits: a cluster RCT.
      Pediatrics. 2015; 135: e296-304https://doi.org/10.1542/peds.2014-2888
      ,
      • Beck A.F.
      • Klein M.D.
      • Kahn R.S.
      Identifying social risk via a clinical social history embedded in the electronic health record.
      Clin Pediatr. 2012; 51: 972-977https://doi.org/10.1177/0009922812441663
      ]. Existing work in the area of social interventions has largely focused on pediatric primary care settings [
      • Fleegler E.W.
      • Lieu T.A.
      • Wise P.H.
      • Muret-Wagstaff S.
      Families' health-related social problems and missed referral opportunities.
      Pediatrics. 2007; 119: e1332-41https://doi.org/10.1542/peds.2006-1505
      ,
      • Garg A.
      • Toy S.
      • Tripodis Y.
      • Silverstein M.
      • Freeman E.
      Addressing social determinants of health at well child care visits: a cluster RCT.
      Pediatrics. 2015; 135: e296-304https://doi.org/10.1542/peds.2014-2888
      ,
      • Garg A.
      • Marino M.
      • Vikani A.R.
      • Solomon B.S.
      Addressing families' unmet social needs within pediatric primary care: the health leads model.
      Clin Pediatr. 2012; 51: 1191-1193https://doi.org/10.1177/0009922812437930
      ]. Yet low-income patients seen in emergency departments and urgent care centers often lack contact with primary care clinics [
      • Data Resource Center for Child and Adolescent Health
      Title V National Performance Measure #11.2: percent of children with and without special health care needs having a medical home.
      http://childhealthdata.org/browse/rankings/maps?s=121
      Date accessed: April 17, 2007
      ] or public assistance networks [
      • Gordon J.A.
      • Chudnofsky C.R.
      • Hayward R.A.
      Where health and welfare meet: social deprivation among patients in the emergency department.
      J Urban Health. 2001; 78: 104-111https://doi.org/10.1093/jurban/78.1.104
      ,
      • Gordon J.A.
      The hospital emergency department as a social welfare institution. Ann of.
      Emerg Med. 1999; 33: 321-325
      ] and frequently use acute settings for non-urgent issues [
      • Zimmer K.P.
      • Walker A.
      • Minkovitz C.S.
      Epidemiology of pediatric emergency department use at an urban medical center.
      Pediatr Emerg Care. 2005; 21: 84-89
      ]. As a result, low-income children may miss opportunities for social resource linkages.

      Keywords

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      References

        • American Academy of Pediatrics Council On Community
        Poverty and child health in the United States.
        Pediatrics. 2016; 137https://doi.org/10.1542/peds.2016-0339
        View in Article
        • APA Task Force on Childhood Poverty
        A strategic road-map: committed to bringing the voice of pediatricians to the most important problem facing children in the US today.
        http://www.ambpeds.org/public_policy/pdf/APA_Task_Force_Strategic_Road_Mapver3.pdf
        Date: 2003
        Date accessed: April 7, 2017
        View in Article
        • American Academy of Pediatrics Medical Home Initiatives for Children with Special Needs Project Advisory Committee
        The medical home.
        Pediatrics. 2002; 110: 184-186
        View in Article
        • American Academy on Pediatrics Committee on Community Health Services
        The pediatrician's role in community pediatrics.
        Pediatrics. 2005; 115: 1092-1094https://doi.org/10.1542/peds.2004-2680
        View in Article
        • Baer T.E.
        • Gottlieb L.
        • Sandel M.
        Addressing social determinants of health in the adolescent medical home.
        Curr Opin Pediatr. 2013; 25: 447-453https://doi.org/10.1097/MOP.0b013e32836280ae
        View in Article
        • Chung E.K.
        • Siegel B.S.
        • Garg A.
        • Conroy K.
        • Gross R.S.
        • Long D.A.
        • et al.
        Screening for social determinants of health among children and families living in poverty: a guide for clinicians.
        Curr Probl Pediatr Adolesc Health Care. 2016; 46: 135-153https://doi.org/10.1016/j.cppeds.2016.02.004
        View in Article
        • Fieldston E.S.
        • Zaniletti I.
        • Hall M.
        • Colvin J.D.
        • Gottlieb L.
        • Macy M.L.
        • et al.
        Community household income and resource utilization for common inpatient pediatric conditions.
        Pediatrics. 2013; 132: e1592-601https://doi.org/10.1542/peds.2013-0619
        View in Article
        • Colvin J.D.
        • Zaniletti I.
        • Fieldston E.S.
        • Gottlieb L.M.
        • Raphael J.L.
        • Hall M.
        • et al.
        Socioeconomic status and in-hospital pediatric mortality.
        Pediatrics. 2013; 131: e90-e182https://doi.org/10.1542/peds.2012-1215
        View in Article
        • Fleegler E.W.
        • Lieu T.A.
        • Wise P.H.
        • Muret-Wagstaff S.
        Families' health-related social problems and missed referral opportunities.
        Pediatrics. 2007; 119: e1332-41https://doi.org/10.1542/peds.2006-1505
        View in Article
        • Garg A.
        • Toy S.
        • Tripodis Y.
        • Silverstein M.
        • Freeman E.
        Addressing social determinants of health at well child care visits: a cluster RCT.
        Pediatrics. 2015; 135: e296-304https://doi.org/10.1542/peds.2014-2888
        View in Article
        • Beck A.F.
        • Klein M.D.
        • Kahn R.S.
        Identifying social risk via a clinical social history embedded in the electronic health record.
        Clin Pediatr. 2012; 51: 972-977https://doi.org/10.1177/0009922812441663
        View in Article
        • Garg A.
        • Marino M.
        • Vikani A.R.
        • Solomon B.S.
        Addressing families' unmet social needs within pediatric primary care: the health leads model.
        Clin Pediatr. 2012; 51: 1191-1193https://doi.org/10.1177/0009922812437930
        View in Article
        • Data Resource Center for Child and Adolescent Health
        Title V National Performance Measure #11.2: percent of children with and without special health care needs having a medical home.
        http://childhealthdata.org/browse/rankings/maps?s=121
        Date accessed: April 17, 2007
        View in Article
        • Gordon J.A.
        • Chudnofsky C.R.
        • Hayward R.A.
        Where health and welfare meet: social deprivation among patients in the emergency department.
        J Urban Health. 2001; 78: 104-111https://doi.org/10.1093/jurban/78.1.104
        View in Article
        • Gordon J.A.
        The hospital emergency department as a social welfare institution. Ann of.
        Emerg Med. 1999; 33: 321-325
        View in Article
        • Zimmer K.P.
        • Walker A.
        • Minkovitz C.S.
        Epidemiology of pediatric emergency department use at an urban medical center.
        Pediatr Emerg Care. 2005; 21: 84-89
        View in Article
        • Gottlieb L.M.
        • Hessler D.
        • Long D.
        • Laves E.
        • Burns A.R.
        • Amaya A.
        • et al.
        Effects of social needs screening and in-person service navigation on child health: a randomized clinical trial.
        JAMA Pediatr. 2016; e162521https://doi.org/10.1001/jamapediatrics.2016.2521
        View in Article
        • Zickafoose J.S.
        • Gebremariam A.
        • Davis M.M.
        Medical home disparities for children by insurance type and state of residence.
        Matern Child Health J. 2012; 16: S178-187https://doi.org/10.1007/s10995-012-1008-9
        View in Article

      Article Info

      Publication History

      Published online: March 15, 2018
      Accepted: March 15, 2018
      Received in revised form: March 15, 2018
      Received: April 17, 2017

      Identification

      DOI: https://doi.org/10.1016/j.ajem.2018.03.034

      Copyright

      © 2018 Elsevier Inc. All rights reserved.

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