October 2018 Research Round-Up

Below we highlight recent literature on screening for and/or addressing social needs in clinical settings. To receive the Research Round-Up in your email, sign up for our monthly newsletter.

Find these articles and many more in our searchable Evidence Library.

Research Articles

Food Insecurity, Healthcare Utilization, and High Cost: A Longitudinal Cohort Study
S.A. Berkowitz, H.K. Seligman, J.B. Meigs, & S. Basu
American Journal of Managed Care
This study based on a nationally representative cohort found that food insecurity was associated with higher healthcare use and costs, even after accounting for sociodemographics.

Value of Neighborhood Socioeconomic Status in Predicting Risk of Outcomes in Studies That Use Electronic Health Record Data
N.A. Bhavsar, A. Gao, M. Phelan, et al.
JAMA Network Open
This study of data from 90,000 patients in Durham County, North Carolina found that adding neighborhood socioeconomic status data to predictive models that included EHR variables did not improve model performance for any of the outcomes studied.

Predictive Modeling of Housing Instability and Homelessness in the Veterans Health Administration
T. Byrne, A.E. Montgomery, & J.D. Fargo
Health Services Research
This study developed and tested predictive models of housing instability and homelessness in Veterans based on medical record data.

Child Abuse and Neglect Risk Assessment: Quality Improvement in a Primary Care Setting
E.K. Chung, R.S. Gubernick, M. LaNoue, & D.J. Abatemarco
Academic Pediatrics
This study describes a quality improvement initiative that successfully improved child abuse and neglect risk assessment and resource provision through the use of EHR tools.

A Dual-Method Approach to Identifying Intimate Partner Violence Within a Level 1 Trauma Center
S. DiVietro, R. Beebe, D. Grasso, C. Green, D. Joseph, & G.D. Lapidus
The Journal of Trauma and Acute Care Surgery
This study found that tablet-based screen followed by face-to-face assessment resulted in more positive IPV screenings than either method on its own.

Caring for "Super-Utilizers": Neoliberal Social Assistance in the Safety-Net
M.D. Fleming, J.K. Shim, I. Yen, M. Van Natta, C. Hanssmann, & N.J. Burke
Medical Anthropology Quarterly
This ethnographic study examines how the provision of social needs assistance to complex patients involves the negotiation and alignment of economistic values with ethics of care.

Medicare Beneficiaries Living in Housing with Supportive Services Experienced Lower Hospital Use Than Others
M.K. Gusmano, V.G. Rodwin, & D. Weisz
Health Affairs
This study found that hospital discharge rates were 32 percent lower, hospital lengths-of-stay one day shorter, and ACSC rates 30 percent lower among Medicare beneficiaries living in housing with supportive social services compared to Medicare beneficiaries in the same neighborhoods but in buildings without those services.

Perceptions and Experience of Patients, Staff, and Clinicians with Social Needs Assessment
C. Hamity, A. Jackson, L. Peralta, & J. Bellows
Permanente Journal
This study of patient and staff perceptions of social needs assessments at Kaiser Permanente found that both groups understood and supported the health system's social needs screening but emphasized the importance of assessments yielding actionable information. Patients also raised concerns about how information about their social needs would be used and by whom.

Whole Person Care in Under-resourced Communities: Stakeholder Priorities at Long-Term Follow-Up in Community Partners in Care
D. Khodyakov, M.Z. Sharif, F. Jones, et al.
Ethnicity & Disease
This qualitative study of depressed Latino and African American clients and the organizations that assist them found that program representatives understand the complexity of clients' needs.

Costs Associated with Health Care Services Accessed through VA and in the Community through Medicare for Veterans Experiencing Homelessness
R.E. Nelson, Y. Suo, W. Pettey, et al.
Health Services Research
This evaluation of health care utilization and costs in veteran populations found that participation in a VA homelessness program was associated with a decrease in use of Medicare outpatient services.

Timing and Duration of Pre- and Postnatal Homelessness and the Health of Young Children
M. Sandel, R. Sheward, S. Ettinger de Cuba, et al.
Pediatrics
This observational study among 20,571 children, found that, after controlling for birth outcomes, prenatal and postnatal homelessness was associated with an increased risk of adverse pediatric health outcomes relative to those who were never homeless.

Inpatient Medicaid Usage and Expenditure Patterns After Changes in Supplemental Nutrition Assistance Program Benefit Levels
R.A. Sonik, S.L. Parish, & M. Mitra
Preventing Chronic Disease
This study found that changes in SNAP benefits levels in 2009 and 2013 were associated with changes in inpatient Medicaid usage and cost patterns.

Lessons Learned from Implementation of the Food Insecurity Screening and Referral Program at Kaiser Permanente Colorado
S.H. Stenmark, J.F. Steiner, S. Marpadga, M. Debor, K. Underhill, & H. Seligman
Permanente Journal
This article describes barriers encountered and lessons learned from the implementation and expansion of a clinical food insecurity screening and referral program, which operates in collaboration with a statewide organization to manage clinic-to-community referrals.

Indianapolis Provider's Use of Wraparound Services Associated with Reduced Hospitalizations and Emergency Department Visits
J.R. Vest, L.E. Harris, D.P. Haut, P.K. Halverson, N. Menachemi
Health Affairs
This study of social and behavioral wrap-around services in FQHCs found that receipt of wraparound services was associated with lower subsequent hospitalizations and emergency department visits, resulting in estimated cost savings of $1.4 million annually from potentially avoided hospitalizations alone.

Reports

Medical-Legal Partnership Interventions and Child Development: Cross-sector Partnerships to Address Social Determinants of Health
K.A. Ruble, K. Mitchell, K. Sease
Institute for Child Success
This report outlines the structure, services, and outcomes associated with Medical-Legal Partnerships, explores the growth and utilization of MLPs in South Carolina, and identifies opportunities to strengthen MLP service delivery for improved public health.