1
|
Starling CM, Smith M, Kazi S, Milicia A, Grisham R, Gruber E, Blumenthal J, Arem H. Understanding social needs screening and demographic data collection in primary care practices serving Maryland Medicare patients. BMC Health Serv Res 2024; 24:448. [PMID: 38600578 PMCID: PMC11005183 DOI: 10.1186/s12913-024-10948-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 04/03/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Health outcomes are strongly impacted by social determinants of health, including social risk factors and patient demographics, due to structural inequities and discrimination. Primary care is viewed as a potential medical setting to assess and address individual health-related social needs and to collect detailed patient demographics to assess and advance health equity, but limited literature evaluates such processes. METHODS We conducted an analysis of cross-sectional survey data collected from n = 507 Maryland Primary Care Program (MDPCP) practices through Care Transformation Requirements (CTR) reporting in 2022. Descriptive statistics were used to summarize practice responses on social needs screening and demographic data collection. A stepwise regression analysis was conducted to determine factors predicting screening of all vs. a targeted subset of beneficiaries for unmet social needs. RESULTS Almost all practices (99%) reported conducting some form of social needs screening and demographic data collection. Practices reported variation in what screening tools or demographic questions were employed, frequency of screening, and how information was used. More than 75% of practices reported prioritizing transportation, food insecurity, housing instability, financial resource strain, and social isolation. CONCLUSIONS Within the MDPCP program there was widespread implementation of social needs screenings and demographic data collection. However, there was room for additional supports in addressing some challenging social needs and increasing detailed demographics. Further research is needed to understand any adjustments to clinical care in response to identified social needs or application of data for uses such as assessing progress towards health equity and the subsequent impact on clinical care and health outcomes.
Collapse
Affiliation(s)
- Claire M Starling
- Implementation Science, Healthcare Delivery Research Program, MedStar Health Research Institute, 6525 Belcrest Road, Suite 700, Hyattsville, MD, 20782, USA.
| | - Marjanna Smith
- Implementation Science, Healthcare Delivery Research Program, MedStar Health Research Institute, 6525 Belcrest Road, Suite 700, Hyattsville, MD, 20782, USA
| | - Sadaf Kazi
- Department of Emergency Medicine, Georgetown University School of Medicine, 3900 Reservoir Road, Washington, NWDC, 20007, USA
- National Center for Human Factors in Healthcare, MedStar Health Research Institute, 3007 Tilden St.Suite 6N, Washington, NWDC, 20008, USA
| | - Arianna Milicia
- National Center for Human Factors in Healthcare, MedStar Health Research Institute, 3007 Tilden St.Suite 6N, Washington, NWDC, 20008, USA
| | - Rachel Grisham
- Maryland Primary Care Program, Maryland Department of Health, 201 W. Preston Street, Baltimore, MD, 21201, USA
| | - Emily Gruber
- Maryland Primary Care Program, Maryland Department of Health, 201 W. Preston Street, Baltimore, MD, 21201, USA
| | - Joseph Blumenthal
- MedStar Center for Biostatistics, Informatics and Data Science, MedStar Health Research Institute, 3007 Tilden St.Suite 6N, Washington, NWDC, 20008, USA
| | - Hannah Arem
- Implementation Science, Healthcare Delivery Research Program, MedStar Health Research Institute, 6525 Belcrest Road, Suite 700, Hyattsville, MD, 20782, USA
- Department of Oncology, Georgetown University School of Medicine, 3900 Reservoir Road, Washington, NWDC, 20007, USA
| |
Collapse
|
2
|
Shurson L, Godfrey T, Flamm K, Bertsch M, Broughton E, Prettyman A. Utilizing Academic–Service Partnerships to Advance the Care of Veterans. J Nurse Pract 2021. [DOI: 10.1016/j.nurpra.2021.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
3
|
Ryan MS, Leggio LE, Peltier CB, Chatterjee A, Arenberg S, Byerley JS, Belkowitz JL, Rabalais GP, Barone MA. Recruitment and Retention of Community Preceptors. Pediatrics 2018; 142:peds.2018-0673. [PMID: 30115732 DOI: 10.1542/peds.2018-0673] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/20/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Recruiting and retaining community-based pediatricians for teaching medical students has been explored through the lens of preceptors and educational leaders. The purpose of this study was to explore the perspective of pediatric department chairs, a key stakeholder group charged with maintaining teaching capacity among a faculty. METHODS In 2015, members of the Association of Medical School Pediatric Department Chairs and Council on Medical Student Education in Pediatrics joint task force disseminated a 20-item survey to pediatric department chairs in the United States and Canada. Topics included demographics, incentives offered to community pediatricians, and the perceived value and feasibility of such incentives. Data were analyzed using descriptive statistics and χ2 to compare categorical variables. RESULTS Pediatric department chairs from 92 of 145 (63% response rate) medical schools returned the survey. Sixty-seven percent reported difficulty recruiting or retaining preceptors, and 51% reported high-reliance on preceptors for the ambulatory portion of the pediatrics clerkship. Almost all (92%) cited competition from other programs for the services of community preceptors. The provision of incentives was correlated with perceived feasibility (R2 = 0.65) but not their perceived value (R2 = 0.12). Few (21%) chairs reported providing financial compensation to preceptors. The provision of compensation was not related to reliance but did vary significantly by geographical region (P < .001). CONCLUSIONS Pediatric departments rely heavily on community-based pediatricians but face competition from internal and external training programs. The perspective of department chairs is valuable in weighing interventions to facilitate continued recruitment and retention of community preceptors.
Collapse
Affiliation(s)
- Michael S Ryan
- Department of Pediatrics, School of Medicine, Virginia Commonwealth University, Richmond, Virginia;
| | - Lisa E Leggio
- Department of Pediatrics, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Christopher B Peltier
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio
| | - Archana Chatterjee
- Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Vermillion, South Dakota
| | - Steven Arenberg
- Marketing and Communications, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Julie S Byerley
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Julia L Belkowitz
- Department of Pediatrics, Miller School of Medicine, University of Miami, Miami, Florida; and
| | - Gerard P Rabalais
- Department of Pediatrics, School of Medicine, University of Louisville, Louisville, Kentucky
| | | |
Collapse
|