Unmet Social Needs and No-Show Visits in Primary Care in a US Northeastern Urban Health System, 2018-2019
Unmet Social Needs and No-Show Visits in Primary Care in a US Northeastern Urban Health System, 2018-2019
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DOI：
10.2105/ajph.2020.305717
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发表时间：
2020-07-01
影响因子：
12.7
通讯作者：
Racine, Andrew
中科院分区：
文献类型：
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作者：
Fiori, Kevin P.;Heller, Caroline G.;Racine, Andrew
目标.描述社会需求流行率和未出现比例之间的关联以及这些关联在特定社会需求中的变化。在这项研究中，我们使用了2018年4月至2019年7月期间在纽约布朗克斯县大型城市卫生系统的19个初级保健实践中进行的10项社会需求筛选的结果。我们使用负二项回归模型估计了41637例患者未满足的需求与2年错过预约史之间的关系。整体预约缺席比例为26.6%。调整后的模型表明，有1个或多个社会需求的患者的未出现比例（31.5%）显著高于没有任何社会需求的患者（26.3%），增加了19.8%（P <0.001）。我们观察到报告的社交需求数量与未出现比例之间存在正趋势（P <0.001）-没有需求的人为26.3%，1个需求为30.0%，2个需求为32.1%，3个或更多需求为33.8%。有医疗交通需求者与无医疗交通需求者的相关性最强（36.0% vs 26.9%）。我们发现，未满足的社会需求与错过初级保健预约有显着关联，对卫生系统的成本，质量和可及性有潜在影响。
Objectives. To characterize the association between social needs prevalence and no-show proportion and variation in these associations among specific social needs.Methods. In this study, we used results from a 10-item social needs screener conducted across 19 primary care practices in a large urban health system in Bronx County, New York, between April 2018 and July 2019. We estimated the association between unmet needs and 2-year history of missed appointments from 41 637 patients by using negative binomial regression models.Results. The overall no-show appointment proportion was 26.6%. Adjusted models suggest that patients with 1 or more social needs had a significantly higher no-show proportion (31.5%) than those without any social needs (26.3%), representing an 19.8% increase (P < .001). We observed a positive trend (P < .001) between the number of reported social needs and the no-show proportion-26.3% for those with no needs, 30.0% for 1 need, 32.1% for 2 needs, and 33.8% for 3 or more needs. The strongest association was for those with health care transportation need as compared with those without (36.0% vs 26.9%).Conclusions. We found unmet social needs to have a significant association with missed primary care appointments with potential implications on cost, quality, and access for health systems.