The following is a summary of “Assessing Differences in Social Determinants of Health Screening Rates in a Large, Urban Safety-Net Health System,” published in the November 2023 issue of Primary Care by Lindenfeld, et al.
While prior studies have assessed the implementation of standardized social determinants of health (SDOH) screening in healthcare settings, little was known about potential screening disparities after the initial implementation, particularly related to facility characteristics. For a study, researchers sought to examine differences in SDOH screening rates within a large urban healthcare system.
Electronic health record data from NYC Health + Hospitals primary care sites were collected from 2019-2022. The mean number of SDOH screenings was calculated based on visit type, facility size, and the percentages of community characteristics. Four logistic regression models were constructed to predict the odds of SDOH screening, both general and specific to housing, food, and medical cost assistance, based on facility type, facility size, and the socioeconomic characteristics of the surrounding community.
Out of the 3,212,650 included visits, 16.90% underwent SDOH screening. Across all four multivariate logistic regression models predicting SDOH screening, visits had significantly lower odds of being screened if they occurred at midsize or small facilities, were telemedicine visits, or were based in facilities located in zip codes with higher percentages of SDOH needs.
The study identified substantial differences in SDOH screening rates within a large New York City-based health system. Specifically, it highlighted barriers associated with facility size and telemedicine workflows that must be addressed to enhance SDOH screening adoption in various visit and facility types.