金融紧张问题对预先选个人社会风险的预测价值
Emma L Tucher1,2, Nathan Tran3, Laura M Gottlieb4
1Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA. emma.l.tucher@kp.org.
Journal of general internal medicine
|May 6, 2025
概括
财务压力预先选可能会错过超过10%的粮食不安全,住房不稳定或交通障碍的人. 这凸显了仅仅利用财务压力来识别卫生系统中的所有社会风险的局限性.
科学领域:
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
- 健康的社会决定因素
背景情况:
- 社会风险对健康结果和医疗保健成本产生重大影响.
- 卫生系统越来越多地实施社会风险查,但面临临临床医生倦怠和财务权衡等挑战.
- 建议采用两步选方法,使用财务压力作为初始选,以减少实施负担.
研究的目的:
- 评估金融紧张选器的预测价值,作为识别其他社会风险的初步工具.
- 评估金融压力选在检测粮食不安全,住房不稳定和交通障碍方面的有效性.
主要方法:
- 一项纵向研究分析了来自OCHIN,Humana和Kaiser Permanente (n=252,845名成年人) 的数据.
- 该研究评估了金融压力的预测性能 (灵敏度,特异性,PPV,NPV,AUC) 作为预先选器.
- 关于财务压力,粮食不安全,住房不稳定和交通障碍的数据是通过调查和遭遇数据收集的.
主要成果:
- 财务压力的普遍性在数据集之间有所不同 (28%至41%).
- 使用财务压力作为唯一的预先选方法可能会错过12.3%24.2%的粮食不安全个体.
- 这种方法也可能会错过13.2%24.7%的住房不稳定,17.0%32.6%的交通障碍,以及4.1%5.7%的三个.
结论:
- 仅仅使用财务压力预先选器就不足以在医疗保健机构全面识别社会风险.
- 仅仅依靠财务压力可能会导致严重低估遭受其他关键社会风险的个人.
- 卫生系统应该考虑更强大的查策略,以避免错过弱势群体.
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