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首页> 外文期刊>BMC Family Practice >Community health center provider ability to identify, treat and account for the social determinants of health: a card study
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Community health center provider ability to identify, treat and account for the social determinants of health: a card study

机译：社区卫生中心提供者识别，治疗和解释健康的社会决定因素的能力：卡片研究

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Background The social determinants of health (SDH) are conditions that shape the overall health of an individual on a continuous basis. As momentum for addressing social factors in primary care settings grows, provider ability to identify, treat and assess these factors remains unknown. Community health centers care for over 20-million of America’s highest risk populations. This study at three centers evaluates provider ability to identify, treat and code for the SDH. Methods Investigators utilized a pre-study survey and a card study design to obtain evidence from the point of care. The survey assessed providers’ perceptions of the SDH and their ability to address them. Then providers filled out one anonymous card per patient on four assigned days over a 4-week period, documenting social factors observed during encounters. The cards allowed providers to indicate if they were able to: provide counseling or other interventions, enter a diagnosis code and enter a billing code for identified factors. Results The results of the survey indicate providers were familiar with the SDH and were comfortable identifying social factors at the point of care. A total of 747 cards were completed. 1584 factors were identified and 31?% were reported as having a service provided. However, only 1.2?% of factors were associated with a billing code and 6.8?% received a diagnosis code. Conclusions An obvious discrepancy exists between the number of identifiable social factors, provider ability to address them and documentation with billing and diagnosis codes. This disparity could be related to provider inability to code for social factors and bill for related time and services. Health care organizations should seek to implement procedures to document and monitor social factors and actions taken to address them. Results of this study suggest simple methods of identification may be sufficient. The addition of searchable codes and reimbursements may improve the way social factors are addressed for individuals and populations.
机译：背景健康的社会决定因素（SDH）是持续影响个人整体健康的条件。随着解决初级保健环境中社会因素的势头越来越大，提供者识别，治疗和评估这些因素的能力仍然未知。社区保健中心为2000万美国最高风险人群提供服务。在三个中心进行的这项研究评估了提供商识别，治疗和编码SDH的能力。方法研究人员利用研究前调查和卡片研究设计来获得护理方面的证据。这项调查评估了提供者对SDH的看法及其解决方案的能力。然后，提供者在四个星期内的四个指定日期为每位患者填写一张匿名卡，记录在相遇中观察到的社会因素。这些卡使提供者可以指示他们是否能够：提供咨询或其他干预措施，输入诊断代码，并输入已识别因素的账单代码。结果调查结果表明，提供者熟悉SDH，并愿意在护理时确定社会因素。总共完成了747张卡片。确定了1584个因素，并报告有31％的人提供了服务。但是，只有1.2％的因素与帐单代码相关，而6.8％的因素与诊断代码相关。结论可识别的社会因素的数量，提供者解决这些问题的能力以及带有计费和诊断代码的文档之间存在明显的差异。这种差异可能与提供商无法编码社会因素以及无法为相关时间和服务付费有关。卫生保健组织应寻求实施程序来记录和监视社会因素以及为解决这些问题而采取的行动。这项研究的结果表明，简单的鉴定方法可能就足够了。可搜索的代码和报销的增加可能会改善解决个人和人群的社会因素的方式。

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