Analysis of Resident Conducted Social Determinants of Health Informed Home Visits

Date

2020-01-21

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Abstract

CONTEXT: Home visits can improve quality of care, save money, improve health outcomes, and provide a unique opportunity for residents to learn more about patients' social context and assess the various social determinants of health (SDH) that impact patients' health and wellbeing. In order to facilitate a SDH-focused visit, the Department of Family and Community Medicine at UT Southwestern implemented a brief SDH questionnaire in all home visits. OBJECTIVE: The objective of this study is to assess patient self-reported SDH and resident reflections on patient social status, the utility of a SDH survey during home visits, and resident comfort levels with addressing patient SDH HUMAN SUBJECTS REVIEW: This study was approved as an "exempt" study by the UTSW IRB DESIGN: Mixed methods pilot study utilizing patient self-reported data and open- ended reflection questions SETTINGS: Home health visits for patients from an urban safety-net clinic in Dallas, TX. Participants: Adult patients >18 years of age, selected by the resident INTERVENTION/INSTRUMENT (AS PERTINENT): Quantitative survey domains include: demographics, financial status, social support, safety, employment, and living conditions. Open response questions queried resident impressions of the survey, comfort during the interview, new insights about the patient, impact on future practice, and ability to address SDH concerns. ANTICIPATED RESULTS: 42 surveys collected from 42 home visits. Most patients were female (61.9%) and African-American (45.2%), aging from 25 to 88 years (mean=60.24). Prevalence of adverse SDH were relatively low. Common themes of resident responses: positive utility of the survey as a guide for understanding and assessing patient SDH; wide variation in comfort level when inquiring about patient SDH with positive influence from prior experience, assistance from colleagues, or prior good relations with patients; and expressed intention to include SDH assessment in their continuing career. CONCLUSIONS: Residents recognized the value of assessing SDH during home visits and expressed implement a standardized process for selecting patients for home visits as this was largely left to the discretion of the resident. More thorough assessment of patient SDH may help to craft a more robust and standardized system to prioritize patients that would most benefit from receiving home visits.

General Notes

The 58th Annual Medical Student Research Forum at UT Southwestern Medical Center (Tuesday, January 21, 2020, 3-6 p.m., D1.600)

Table of Contents

Subjects

Clinical Research, Education, Medical, Graduate, House Calls, Outcome Assessment, Health Care, Quality of Health Care, Social Determinants of Health

Citation

Cline, M., Day, P., Gimpel, N., & Pagels, P. (2020, January 21). Analysis of resident conducted social determinates of health informed home visits. Poster session presented at the 58th Annual Medical Students Research Forum, Dallas, TX. Retrieved from https://hdl.handle.net/2152.5/8259

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