자료유형  

 학위논문

Control Number  

0016931426

International Standard Book Number  

9798379795153

Dewey Decimal Classification Number  

614

Main Entry-Personal Name  

Nobles, Autumn.

Publication, Distribution, etc. (Imprint  

[S.l.] : Yale University., 2023

Publication, Distribution, etc. (Imprint  

Ann Arbor : ProQuest Dissertations & Theses, 2023

Physical Description  

1 online resource(46 p.)

General Note  

Source: Dissertations Abstracts International, Volume: 85-01, Section: B.

General Note  

Advisor: Wang, Karen.

Dissertation Note  

Thesis (M.D.)--Yale University, 2023.

Restrictions on Access Note  

This item must not be sold to any third party vendors.

Summary, Etc.  

요약Social needs screenings within healthcare systems have grown more common with increasing discourse around the contribution of systemic determinants to health outcomes. These screenings have been used to describe the prevalence of social needs within communities but have not been evaluated for the impact that they and the interventions to which they are attached may have on health outcomes. Here we evaluate social needs screenings and their potential impact on patient health at a federally qualified health center in New Haven, Connecticut. We describe the baseline needs at the facility, evaluate change in reported social needs among patients undergoing screening, and factors associated with decreases in reported social needs. Our analysis uses two samples, to reflect broad health data and emergency room utilization among patients screened for social needs at our study site. For both samples, the socio-demographic, clinical characteristics of those who screened positive and those who screened negative was compared using chi square and t-tests. Multivariable logistic regression was used to determine the socio-demographic factors associated with reported social needs at the initial visit, and social need persistence at the last registered visit. Change in emergency room utilization pre- and post-social needs screening was compared using a paired t-test.Within our first sample, the majority of the sample screened positive for at least one social need. The most commonly reported social needs were financial stain, food insecurity, and employment. At the index visit, those screening positive for social needs were younger, more likely to use English as a primary language, and less likely to be on Commercial or Medicare insurance. At the final screening, 16.4% of those who screened positive at their initial assessment reported no social needs. Thirty-six percent of those with no reported social needs at the index visit now reported at least one new need. Screening positive for any need at the last visit was only associated with younger age. For sample two, the majority also screened positive for at least one need with the most common needs being financial strain, food, and living situation. The majority of the sample screening positive for social needs only had 1 or 2 social needs identified. Factors associated with screening positive were younger age, English as the preferred language, and a medical history without diabetes and stroke history. The mean number of emergency room visits before initial and after final screenings were 1.18 and 0.98, respectively, a significant difference. Overall, our results suggest that the integration of social needs screening with a referral to care coordinator can identify social needs and may alleviate patients' social needs.

Subject Added Entry-Topical Term  

Health sciences.

Subject Added Entry-Topical Term  

Medicine.

Subject Added Entry-Topical Term  

Health care management.

Index Term-Uncontrolled  

Social needs screenings

Index Term-Uncontrolled  

Health outcomes

Index Term-Uncontrolled  

Emergency room utilization

Added Entry-Corporate Name  

Yale University Yale School of Medicine

Host Item Entry  

Dissertations Abstracts International. 85-01B.

Host Item Entry  

Dissertation Abstract International

Electronic Location and Access  

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Control Number  

joongbu:642289