Screening for Health-Related Social Needs and Collaboration With External Partners Among US Hospitals

Area of Science:

• Health Services Research
• Public Health
• Health Equity

Background:

• Hospitals increasingly screen for social needs, but national data on screening and interventions for health-related social needs (HRSNs) and social determinants of health (SDOH) are limited.
• Understanding the landscape of hospital practices is crucial for addressing health disparities.

Purpose of the Study:

• To assess the association between hospital characteristics and area-level socioeconomic indicators with hospitals' screening practices, interventions, and external partnerships for HRSNs and SDOH.
• To quantify the extent of hospitals' engagement in addressing patients' social needs.

Main Methods:

• A cross-sectional study using the 2020 American Hospital Association Annual Survey Database.
• Included general-service, acute-care, nonfederal US hospitals.
• Analyzed data on hospital screening for 8 HRSNs, strategies for 8 HRSNs, and 14 external partnership types, using regression analyses to examine associations with organizational characteristics.

Main Results:

• Most hospitals (79.2%) screened for at least one HRSN, commonly food insecurity and interpersonal violence.
• The majority of hospitals (79.4%) had strategies to address HRSNs, with transportation barriers being a common focus (52.8%).
• Hospitals participating in accountable care contracts (ACCs) and bundled payment programs (BPPs), teaching hospitals, and nonprofit hospitals reported significantly higher screening, intervention, and partnership activities related to HRSNs and SDOH.

Conclusions:

• Most US hospitals are actively screening for and addressing patients' HRSNs.
• Value-based care participation (ACCs, BPPs), teaching status, and nonprofit status are key drivers of comprehensive social needs screening and intervention efforts.
• These findings highlight the impact of financial incentives and organizational structure on advancing health equity initiatives within hospitals.