Are acute care settings amenable to addressing patient social needs: A sub-group analysis

Based on a strong body of evidence linking socioeconomic status and health, interest in patients' social and economic needs is rapidly expanding. This has seeded new research on the feasibility and impact of incorporating interventions that address patients' social needs—like early literacy initiatives, community linkage programs, and legal services—into routine health care delivery. Existing work in the area of social interventions has largely focused on pediatric primary care settings. Yet low-income patients seen in emergency departments and urgent care centers often lack contact with primary care clinics or public assistance networks and frequently use acute settings for non-urgent issues. As a result, low-income children may miss opportunities for social resource linkages.

In 2016, we reported findings from a randomized controlled trial designed to assess the comparative impacts on social needs and child health of two interventions, one involving in-person navigation services provided by a volunteer trained to actively link participants with available social services, and the other a written handout of community-based social service resources. The original study population included patients from both primary care and acute care settings. The full study sample, methods, and results are reported elsewhere. In this sub-group analysis, we examine program impacts on those patients seen in acute care settings only.