Screening for Financial Hardship: Comparing Patient Survey Responses Using Two Different Screening Tools.
Screening for Financial Hardship: Comparing Patient Survey Responses Using Two Different Screening Tools.
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财务困难筛查：使用两种不同的筛查工具比较患者调查反应。
DOI：
10.1007/s11606-023-08437-4
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发表时间：
2024
影响因子：
5.7
通讯作者：
Gottlieb,LauraM
中科院分区：
文献类型：
--
作者：
DeMarchis,EmiliaH;Fleegler,EricW;Cohen,AliciaJ;Tung,ElizabethL;Clark,CherylR;Ommerborn,MarkJ;Lindau,StacyTessler;Pantell,Matt;Hessler,Danielle;Gottlieb,LauraM
医疗保健机构越来越多地使用不同内容和长度的工具来筛查患者的社会风险。目的比较两种包含经济困难相关问题的筛选工具。DesignCross-sectional调查。参与者：三个初级保健诊所的成人患者（n= 471）的方便样本。参与者被随机分配自行完成：(1)由医疗保险和医疗补助服务中心（CMS）开发的筛选工具，包括六个关于经济困难的问题（住房稳定性、住房质量、食品安全、交通安全、公用事业安全）；或(2)美国国家医学院（NAM）推荐的社会和行为风险措施，包括一个关于经济困难（财务压力）的问题。我们比较了患者对筛查的接受程度、经济困难的阳性筛查率、患者对援助的兴趣和自评健康状况。结果91%符合条件或感兴趣的患者完成了相关调查问题，纳入研究（N= 471/516）。患者对这两种工具的接受度都很高，尽管更多的参与者报告在回答CMS和NAM问题时进行筛查是合适的（87%对79%，p= 0.02）。在完成CMS工具的受访者中，57%（132/232）报告了至少一种类型的经济困难；在不结盟运动调查中，52%（125/239）的受访者表示经济困难（p= 0.36）。在完成CMS工具上的项目后，有近两倍的受访者表示对与经济困难相关的援助感兴趣，而不是NAM问题（39%对21%，p< 0.01）。结论患者对两种社会风险评估工具的接受度均较高。虽然两项措施中经济困难的阳性筛查率相似，但更多的患者在回答有关CMS工具上经济困难的问题后表示对援助感兴趣。这可能是因为CMS工具上的筛查问题帮助患者了解筛查后可能提供的与经济困难相关的援助类型。未来的研究应评估个别测量和测量集的效度和比较效度。工具选择应基于设置和服务人群、筛选目标和可用资源。
BackgroundHealthcare delivery organizations are increasingly screening patients for social risks using tools that vary in content and length.ObjectivesTo compare two screening tools both containing questions related to financial hardship.DesignCross-sectional survey.ParticipantsConvenience sample of adult patients (n= 471) in three primary care clinics.Main MeasuresParticipants randomly assigned to self-complete either: (1) a screening tool developed by the Centers for Medicare & Medicaid Services (CMS) consisting of six questions on financial hardship (housing stability, housing quality, food security, transportation security, utilities security); or (2) social and behavioral risk measures recommended by the National Academy of Medicine (NAM), including one question on financial hardship (financial strain). We compared patient acceptability of screening, positive screening rates for financial hardship, patient interest in assistance, and self-rated health.ResultsNinety-one percent of eligible/interested patients completed the relevant survey questions to be included in the study (N= 471/516). Patient acceptability was high for both tools, though more participants reported screening was appropriate when answering the CMS versus NAM questions (87% vs. 79%,p= 0.02). Of respondents completing the CMS tool, 57% (132/232) reported at least one type of financial hardship; on the NAM survey, 52% (125/239) reported financial hardship (p= 0.36). Nearly twice as many respondents indicated interest in assistance related to financial hardship after completing items on the CMS tool than on the NAM question (39% vs. 21%,p< 0.01).ConclusionsPatients reported high acceptability of both social risk assessment tools. While rates of positive screens for financial hardship were similar across the two measures, more patients indicated interest in assistance after answering questions about financial hardship on the CMS tool. This might be because the screening questions on the CMS tool help patients to appreciate the types of assistance related to financial hardship that may be available after screening. Future research should assess the validity and comparative validity of individual measures and measure sets. Tool selection should be based on setting and population served, screening goals, and resources available.
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影响因子：
1.4
作者：
Lewis CC;Wellman R;Jones SMW;Walsh-Bailey C;Thompson E;Derus A;Paolino A;Steiner J;De Marchis EH;Gottlieb LM;Sharp AL
通讯作者：
Sharp AL
影响因子：
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作者：
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通讯作者：
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影响因子：
7.6
作者：
Hassan, Areej;Blood, Emily A.;Fleegler, Eric W.
通讯作者：
Fleegler, Eric W.
捕捉电子健康记录中的社会和行为领域
影响因子：
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作者：
Behavioral Domains
通讯作者：
Behavioral Domains