Evidence Library

This Evidence Library contains research articles, issue briefs, reports, and commentaries that either focus on or are relevant to evaluating health care-based interventions that address patients’ social and economic needs. We prioritize for inclusion resources that carefully describe and evaluate the social needs components of these interventions, and to a lesser extent those where the social components are mentioned but are not the primary focus of the work. The library currently includes only papers published since the year 2000. If you are aware of a resource you think should be added to our Evidence Library, please let us know.

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Displaying 1 - 10 of 28

Living alone and homelessness as predictors of 30-day potentially preventable hospital readmission

E. LaWall, Y.Y. Wu, V. Y. Fan, M. Ashton, T. Sentell
Prev Chronic Dis

Introduction: The effect of social factors on health care outcomes is widely recognized. Health care systems are encouraged to add social and behavioral measures to electronic health records (EHRs), but limited research demonstrates how to leverage this information.

Publication Year:

2019

Resource Type:

Journal Article

Study Design:

Observational

Incorporating social determinants of health in electronic health records: A qualitative study of perspectives on current practices among top vendors

M. Freij, P. Dullabh, L. Hovey, J. Leonard, A. Card, R. Dhopeshwarkar
U.S. Department of Health and Human Services Office of Health Policy

Background: Social determinants of health (SDH) are increasingly seen as important to understanding patient health and identifying appropriate interventions to improve health outcomes, in what is a complex interplay between health system, community, and individual level factors.

Publication Year:

2018

Resource Type:

Issue Brief/Report

Study Design:

Qualitative

Complexities of addressing food insecurity in an urban population

D. Swavely, V. Whyte, J.F. Steiner, S.L. Freeman
Popul Health Manag

There is an association between food insecurity, poor health outcomes, and increased health care spending. The Temple Food Insecurity Program was initiated to screen patients for food insecurity as part of the post Temple University Hospital discharge process.

Publication Year:

2018

Resource Type:

Journal Article

Study Design:

Observational, Qualitative

Development of the pediatric social risk instrument using a structured panel approach

J. Cohen-Silver, S. Adams, R. Agrawal, C. Birken, E. Cohen, G. Dougherty, A. Houtrow, T. Jegathesan, S. Kandasamy, B. Muskat, N. Pai, J.L. Maguire
Clin Pediatr (Phila)

Background: Social determinants of health impact child illness. Currently, no instrument exists to identify social need during hospital admission.

Publication Year:

2018

Resource Type:

Journal Article

Study Design:

Observational, Qualitative

Medical respite for people experiencing homelessness: Financial impacts with alternative levels of Medicaid coverage

D. Shetler, D.S. Shepard
J Health Care Poor Underserved

Medical respite (MR) programs provide medical care, social services, and a safe place to recuperate for people experiencing homelessness after hospital discharge. We examined the financial impact of MR on hospitals and insurers in states with varying Medicaid coverage.

Publication Year:

2018

Resource Type:

Journal Article

Reducing emergency room visits and in-hospitalizations by implementing best practice for transitional care using innovative technology and big data

S. Hewner, S.S. Sullivan, G. Yu
Worldviews Evid Based Nurs

Background: Efforts to improve care transitions require coordination across the healthcare continuum and interventions that enhance communication between acute and community settings.

Publication Year:

2018

Resource Type:

Journal Article

Study Design:

Other Experimental Design

Community navigators reduce hospital utilization in super-utilizers

M.P. Thompson, P.S.B. Podila, C. Clay, J. Sharp, S. Bailey-DeLeeuw, A.J. Berkley, B.G. Baker, T.M. Waters
Am J Manag Care

Objectives: Super-utilizers place a significant burden on the healthcare system. Blending the roles of patient navigators and community health workers may address the clinical and social needs of these patients.

Publication Year:

2018

Resource Type:

Journal Article

Study Design:

Other Experimental Design

ICD social codes: An underutilized resource for tracking social needs

J.M. Torres, J. Lawlor, J.D. Colvin, M.R. Sills, J.L. Bettenhausen, A. Davidson, G.J. Cutler, M. Hall, L.M. Gottlieb
Med Care

Background: Social determinants of health (SDH) data collected in health care settings could have important applications for clinical decision-making, population health strategies, and the design of performance-based incentives and penalties.

Publication Year:

2017

Resource Type:

Journal Article

Study Design:

Observational

The monthly cycle of hypoglycemia: An observational claims-based study of emergency room visits, hospital admissions, and costs in a commercially insured population

S. Basu, S.A. Berkowitz, H. Seligman
Med Care

Background: Multipayer initiatives have sought to address social determinants of health, such as food insecurity, by linking primary care patients to social services. It remains unclear whether such social determinants contribute to avoidable short-term health care costs.

Publication Year:

2017

Resource Type:

Journal Article

Study Design:

Other Experimental Design

Case study: Johns Hopkins Community Health Partnership: A model for transformation

S.A. Berkowitz, P. Brown, D.J. Brotman, A. Deutschendorf, L. Dunbar, A. Everett, D. Hickman, E. Howell, L. Purnell, C. Sylvester, R. Zollinger, M. Bellantoni, S.C. Durso, C. Lyketsos, P. Rothman, J-CHiP Program
Healthc

To address the challenging health care needs of the population served by an urban academic medical center, we developed the Johns Hopkins Community Health Partnership (J-CHiP), a novel care coordination program that provides services in homes, community clinics, acute care hospitals, emergency...

Publication Year:

2016

Resource Type:

Journal Article

Study Design:

Case Study