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[Evaluation of a coding guide on social determinants of health in primary care consultations: A mixed study]

Berta Rodoreda-Pallàs¹, Eva Torra Escarrer², Jaume Sanahuja Juncadella³

¹Grup d'Investigació Promoció de la Salut en l' Àmbit Rural, Gerència d'Atenció Primària i a la Comunitat de la Catalunya Central, Institut Català de la Salut, Sant Fruitós de Bages, Barcelona, España; Centre d'Atenció Primària de Santpedor,EAP Navarcles/Sant Fruitós/Santpedor, Bages, Gerència d'Atenció Primària i a la Comunitat de la Catalunya Central, Institut Català de la Salut, Barcelona, España.

Atencion Primaria

|February 24, 2024

Abstract

Objective:

To evaluate a coding guide for social determinants of health in primary care consultations as an effective tool in the professional's daily workflow.

Design:

Mixed sequential explanatory study. Formed by a quantitative part (experimental) and a qualitative part (descriptive-evaluative).

Location:

All the primary care teams of the Central Catalonia Management (32 teams).

Participants And Setting:

All nursing, social work and medical professionals working in the 32 primary care teams of the Catalan Institute of Health in Central Catalonia from February 2023 to July 2023.

Methods:

A social determinants of health coding guide was developed. This guide was created in a multidisciplinary and multicenter manner. Purposive sampling. Quantitatively, the number of diagnoses recorded by the experimental group versus the control group was counted. Qualitatively, a thematic analysis was carried out from a socio-constructivist perspective.

Results:

The results were significant and satisfactory. Using a quantitative methodology, the effectiveness of the use of the guide was assessed. A significant increase in the use of the social determinants was observed in the intervention group vs. the control group, with a percentage of post-intervention use of 19.53% in the control group and 32.26% in the intervention group (P < .001). The number of diagnoses recorded increased from 312 to 1322 in the intervention group, while it remained the same in the control group. The main factors identified through qualitative methodology that may explain the effectiveness of the guideline were: 1) the effectiveness of the guideline among primary care professionals, 2) the appropriateness of the guideline by assessing its usefulness and practicality, 3) feasibility and 4) specific contributions to the improvement of the guideline.

Conclusions:

The social determinants of health coding guide is effective, appropriate and can be implemented in the workflow of primary health care professionals for good recording of the social determinants of health.

Keywords:

Atención primaria Codificación Coding Determinantes sociales de salud Guide and assessment Guía y evaluación Primary care Registration Registro Social determinants of health

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