Health-related social needs screening, reporting, and assistance in a large health system

National mandates require screening for and addressing health-related social needs (HRSNs) in healthcare settings. However, differences in HRSN screening process (i.e., completed screenings, screening results, documented offer of assistance, documented assistance request) have been reported by population subgroup. Knowledge of the most effective HRSN screening and intervention methods is limited. We sought to describe differences in completed HRSN screenings, screening results, and assistance request rates across patient and healthcare visit characteristics.

We examined data from all patients aged ≥18 years and residing in the US receiving services at a large, Midwestern healthcare system with a goal to screen all patients for HRSN at least once annually between July 2021-June 2023 (n = 1,190,488). We examined the proportion of patients with any HRSN screening, with any reported HRSN, asked whether they wanted assistance, or who requested assistance for a reported HRSN stratified by patient demographics and healthcare visit characteristics (i.e., payer, screening location, who completed the screening).

Less than half of eligible patients (47.0 %) were screened for HRSNs. About one-sixth (16.9 %) reported any HRSN. Although most patients reporting HRSNs were asked whether they wanted assistance, only about one-quarter (26.8 %) responded affirmatively. Proportions included in each step of the HRSN screening process significantly differed by patient and healthcare visit characteristics.

This study is one of the first to investigate various steps of a population-wide HRSN screening program. Our findings suggest that examining differences in HRSN screening process by population subgroup is key to addressing HRSNs through a health equity lens.