Background: Social determinants of health (SDOH) include stable housing, food security, and accessible transportation, and they are not universally identified or addressed in clinical health. Although physicians recognize the importance of screening patients for social needs, current hospital screening practices may only be applied occasionally, can be limited in the types of patients screened, and are lacking in organization. Comprehensive knowledge of social disparities, which is acquired by more effective screening of patients, has the potential to impact healthcare expenditures, which have risen from 1.7 trillion dollars in 2000 to 2.7 trillion dollars in 2015.
Methods: The purpose of this study was to evaluate the socioeconomic needs of patients admitted to a large urban academic medical center. Eligible patients were surveyed from June 20th through July 30th 2018, and demographic and medical history information was extracted from the electronic health record (EHR).
Results: Results revealed 62% of patients had at least one social need. The two most common social needs were difficulty paying for basic necessities (49.5%) and feeling lonely or isolated from other people (35.4%). An analysis was performed examine the relationship between individual social needs and demographic characteristics. Rates of social needs were found to be significantly higher in patients who had a history drug (p<0.01) or alcohol abuse (p<0.05), were currently a smoker (p<0.01), or had no insurance (p<0.05), no primary care provider (p<0.05), or no spouse or partner (p<0.01) listed in their medical record.
Conclusions: Automatic flagging in the EHR system could be used to help care teams identify patients who may benefit from an in-depth social needs screening. These findings indicate that the inpatient hospital setting may be a feasible place to discover and address unmet social needs.