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Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health (2019)

Chapter: Appendix: Social Need Screening Tools Comparison Table

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Suggested Citation:"Appendix: Social Need Screening Tools Comparison Table." National Academies of Sciences, Engineering, and Medicine. 2019. Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health. Washington, DC: The National Academies Press. doi: 10.17226/25467.
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Page 173
Suggested Citation:"Appendix: Social Need Screening Tools Comparison Table." National Academies of Sciences, Engineering, and Medicine. 2019. Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health. Washington, DC: The National Academies Press. doi: 10.17226/25467.
×
Page 174
Suggested Citation:"Appendix: Social Need Screening Tools Comparison Table." National Academies of Sciences, Engineering, and Medicine. 2019. Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health. Washington, DC: The National Academies Press. doi: 10.17226/25467.
×
Page 175
Suggested Citation:"Appendix: Social Need Screening Tools Comparison Table." National Academies of Sciences, Engineering, and Medicine. 2019. Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health. Washington, DC: The National Academies Press. doi: 10.17226/25467.
×
Page 176
Suggested Citation:"Appendix: Social Need Screening Tools Comparison Table." National Academies of Sciences, Engineering, and Medicine. 2019. Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health. Washington, DC: The National Academies Press. doi: 10.17226/25467.
×
Page 177
Suggested Citation:"Appendix: Social Need Screening Tools Comparison Table." National Academies of Sciences, Engineering, and Medicine. 2019. Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health. Washington, DC: The National Academies Press. doi: 10.17226/25467.
×
Page 178

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TABLE A-1  Social Need Screening Tools Comparison Table 174   Medicare Your Total Health Current Health Assessment NAM Life AHC-Tool HealthBegins Leads MLP IHELLP Questionnaire Domains PRAPARE WellRx Situation Number of 19 24 10 10 9 12 17 10 19 social needs questions Number of 8 4 0 0 30 12 4 1 10 non-social needs questions Patient or clinic Medicare Non-specific Non- Non-specific Medicare Non- Community Primary Non-specific population and specific beneficiaries specific Health care Medicaid Centers Reading level 8th grade 11th grade 6th grade 8th grade College 6th grade 8th grade 2nd grade 9th grade Reported NR NR NR NR 10–20 min NR NR NR NR completion time Additional             Spanish Spanish   languages Scoring Y Y N N N N N N N Cost Free Free Free Free Free Free Free Free Free PREPUBLICATION COPY—Uncorrected Proofs Benefitsa       1           Caregiver                 1 responsibilitiesa

Child care     1       1 1 1 access and affordabilitya Civic   1               engagementa Clothinga             1     Disabilitiesa 2                 Educationa 1 3   1   2 1 1   Employmenta 1 1   1     1 2   Financial straina 1 2       1     1 Food insecuritya 2 1 1   2   1 1 3 Health care/     1       2   2 medicine access and affordabilitya Housing 1 2 1 2 1   2 1 2 insecurity/ instability/ homelessnessa Housing 1 1   1 1       1 qualitya Immigration/   1   2     2     PREPUBLICATION COPY—Uncorrected Proofs migrant status/ refugee statusa Incarcerationa             1     Incomea       3   1b 1     175 continued

TABLE A-1 Continued 176   Medicare Your Total Health Current Health Assessment NAM Life AHC-Tool HealthBegins Leads MLP IHELLP Questionnaire Domains PRAPARE WellRx Situation Interpersonal 4 4   3   4 1 2 3 violencea Literacya     1           1 Neighborhood   1         1 1 1 safetya Power of       1 1         attorney/ guardianshipa Social supporta 2 5 1   2 4 1   5 Stressa 1 1     2 1 1   2 Transportationa 1 1 1       1 1 2 Utilitiesa 1   1       2 1 1 Veteran statusa             1     Health MH, PA, DP, PA     AA, DP, HS, AA, MH,   AA, SA   behaviors/ SU MH, PA, TU PA, TU behavioral health/ health PREPUBLICATION COPY—Uncorrected Proofs status

Desire for Integrated Integrated 2 stand- Integrated 1 stand-alone     Integrated 2 stand- assistance/ into some into “civic alone into “Immi- question into some alone urgent needs domains; engagement”; questions gration”; see domains; questions see see domain- domain-spe- see domain- domain- specific cific question specific specific question questions questions NOTE: AA = alcohol abuse; AHC = Accountable Health Communities; DP = dietary pattern; DU = drug use; HC = health confidence; HS = health/ functional status; MH = mental health (including depression); MLP IHELLP = Medical-Legal Partnership Patient Screening Tool; NAM = National Academy of Medicine; NR = not reported; NS = non-specified; PA = physical activity; PRAPARE = Protocol for Responding to and Assessing Patients’ Assets, Risks and Experiences; SU = substance use; TU = tobacco use. a Number refers to number of screening questions about the specified social need. b Geocoded. SOURCE: UCSF (University of California, San Francisco). SIREN: Social Interventions Research and Evaluation Network. 2019. https://sirenetwork. ucsf.edu. Used with permission from Laura Gottlieb and Caroline Fichtenberg. PREPUBLICATION COPY—Uncorrected Proofs 177

178 INTEGRATING SOCIAL CARE INTO THE DELIVERY OF HEALTH CARE REFERENCES Baer, T. E., E. A. Scherer, E W. Fleegler, and A. Hassan. 2015. Food insecurity and the burden of health-related social problems in an urban youth population. Journal of Adolescent Health 57(6):601–607. Gundersen, C., E. E. Engelhard, A. S. Crumbaugh, and H. K. Seligman. 2017. Brief assess- ment of food insecurity accurately identifies high-risk U.S. adults. Public Health and Nutrition 20(8):1367–1371. Hager, E. R., A. M. Quigg, M. M. Black, S. M. Coleman, T. Heeren, R. Rose-Jacobs, J. T. Cook, S. A. Ettinger de Cuba, P. H. Casey, M. Chilton, D. B. Cutts, A. F. Meyers, and D. A. Frank. 2010. Development and validity of a 2-item screen to identify families at risk for food insecurity. Pediatrics 126(1):e26–e32. IOM (Institute of Medicine). 2014. Capturing social and behavioral domains and measures in electronic health records: Phase 2. Washington, DC: The National Academies Press. PREPUBLICATION COPY—Uncorrected Proofs

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The consistent and compelling evidence on how social determinants shape health has led to a growing recognition throughout the health care sector that improving health and health equity is likely to depend – at least in part – on mitigating adverse social determinants. This recognition has been bolstered by a shift in the health care sector towards value-based payment, which incentivizes improved health outcomes for persons and populations rather than service delivery alone. The combined result of these changes has been a growing emphasis on health care systems addressing patients’ social risk factors and social needs with the aim of improving health outcomes. This may involve health care systems linking individual patients with government and community social services, but important questions need to be answered about when and how health care systems should integrate social care into their practices and what kinds of infrastructure are required to facilitate such activities.

Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation’s Health examines the potential for integrating services addressing social needs and the social determinants of health into the delivery of health care to achieve better health outcomes. This report assesses approaches to social care integration currently being taken by health care providers and systems, and new or emerging approaches and opportunities; current roles in such integration by different disciplines and organizations, and new or emerging roles and types of providers; and current and emerging efforts to design health care systems to improve the nation's health and reduce health inequities.

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