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Research ArticleOriginal Research

Patient Interest in Receiving Assistance with Self-Reported Social Risks

Inga Gruß, Alexandra Varga, Neon Brooks, Rachel Gold and Matthew P. Banegas
The Journal of the American Board of Family Medicine September 2021, 34 (5) 914-924; DOI: https://doi.org/10.3122/jabfm.2021.05.210069
Inga Gruß
the Kaiser Permanente Center for Health Research, Portland, OR (IG, AV, NB, RG, MPB).
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Alexandra Varga
the Kaiser Permanente Center for Health Research, Portland, OR (IG, AV, NB, RG, MPB).
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Neon Brooks
the Kaiser Permanente Center for Health Research, Portland, OR (IG, AV, NB, RG, MPB).
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Rachel Gold
the Kaiser Permanente Center for Health Research, Portland, OR (IG, AV, NB, RG, MPB).
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Matthew P. Banegas
the Kaiser Permanente Center for Health Research, Portland, OR (IG, AV, NB, RG, MPB).
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Article Figures & Data

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    Appendix 1.

    Your Current Life Situation Screening Tool

Tables

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    • View popup
    Table 1.

    Baseline Population Characteristics (N = 32,861)

    Total
    Characteristicn (%)
    Sex
        Female17,857 (54.3)
        Male14,987 (45.6)
        Unknown17 (0.1)
    Race/ethnicity
        Asian984 (3.0)
        Black1,388 (4.2)
        Hispanic2,137 (6.5)
        American Indian/Alaskan Native407 (1.2)
        Mixed Race/Other785 (2.4)
        Unknown483 (1.5)
        White27,084 (82.4)
    Age, years
        18 to 292,493 (7.6)
        30 to 392,496 (7.6)
        40 to 493,168 (9.6)
        50 to 594,829 (14.7)
        60 to 697,098 (21.6)
        70 to 797,295 (22.2)
        80 and older5,482 (16.7)
    Insurance type
        Commercial10,428 (31.7)
        Medicaid3,139 (9.6)
        Medicare16,805 (51.1)
        Uninsured2,489 (7.6)
    Neighborhood Deprivation Index (NDI), mean ± SD−0.14 ± 0.69
    Elixhauser score
        Missing1,007 (3.1)
        03,111 (9.5)
        1 to 312,034 (36.6)
        >316,709 (50.9)
    YCLS Respondent
        Patient (self)25,178 (76.6)
        Family member, friend, or caregiver3,646 (11.1)
        Patient with someone's help3,809 (11.6)
        Skip/prefer not to answer228 (0.7)
    Needed language interpreter1,124 (3.4)
    Social risks
        Housing instability4,372 (13.3)
        Food insecurity3,632 (11.1)
        Transportation hardship2,491 (7.6)
        Medical financial hardship2,790 (8.5)
    Requests for help
        Housing2,884 (8.8)
        Food2,105 (6.4)
        Transportation1,863 (5.7)
        Medical financial4,482 (13.6)
    • SD, standard deviation; YCLS, Your Current Life Situation.

    • View popup
    Table 2.

    Request for Help Among Patients Who Reported Having Social Risks by Social Risk Domain

    Requests For Help By Social Risk Domain, n (%)
    Housing instability (N = 4,372)
        No1,756 (40.2)
        Yes2,616 (59.8)
    Food insecurity (N = 3,632)
        No1,756 (48.4)
        Yes1,876 (51.7)
    Transportation hardship (N = 2,491)
        No1,012 (40.6)
        Yes1,479 (59.4)
    Medical financial hardship (N = 2,790)
        No512 (18.4)
        Yes2,278 (81.7)
    • View popup
    Table 3.

    Results of Multivariable Logistic Regression of Risk/Help Concordance by Social Risk Domain

    Housing Instability Risk/Help ConcordanceFood Insecurity Risk/Help ConcordanceTransportation Hardship Risk/Help ConcordanceMedical Financial Hardship Risk/Help Concordance
    ParameterLevelOR95% CIP valueOR95% CIP valueOR95% CIP valueOR95% CIP value
    Lower LimitUpper LimitLower LimitUpper LimitLower LimitUpper LimitLower LimitUpper Limit
    Intercept0.310.210.46<.00010.220.130.38<.00010.960.581.58.884.372.338.20<.0001
    Age, years18 to 291.591.212.00***<.0011.650.992.76*.050.550.350.86*.0051.070.572.00.81
    30 to 392.361.603.46***<.00011.661.022.72*.040.540.350.83**.0041.020.551.86.97
    40 to 493.012.074.38***<.00011.961.193.23.0080.550.360.85**.0061.260.702.24.44
    50 to 592.651.923.65***<.00011.831.142.94**.010.720.481.06.091.600.952.71.07
    60 to 692.101.572.28**.0011.560.992.74*.050.750.4581.05.091.801.122.88**.01
    70 to 791.811.332.47**.00021.230.771.96.380.780.571.08.141.120.751.90.45
    80 and olderReferenceReferenceReferenceReference
    SexF1.080.921.2.321.1070.961.27.1541.271.071.50.0051.100.901.36.332
    MReferenceReferenceReferenceReference
    Race/ethnicityAsian0.920.601.42.7731.490.082.26.0581.020.571.84.9280.960.541.72.902
    Black1.561.212.00***.00061.441.111.86**.0051.070.781.46.6471.270.841.94.248
    Hispanic1.190.921.54.1771.661.252.21***<.0011.430.952.16.0901.580.9992.51.051
    Mixed Race/Other0.970.671.42.9071.170.901.708.3991.020.641.63.9072.121.004.48*.048
    Unknown0.730.451.20.2260.680.421.12.1340.5610.281.10.0950.830.421.62.591
    WhiteReferenceReferenceReferenceReference
    Needs interpreterYes1.521.062.17*.0201.701.172.48**.0051.500.922.44.1031.781.0013.18*.049
    NoReferenceReferenceReferenceReference
    InsuranceMedicaid1.651.342.03***<.00011.371.131.67***.0012.031.572.61***<.00010.560.400.78***<.001
    Medicare0.930.731.18.5731.451.151.82**.0011.771.302.42***<.0010.870.621.21.426
    Uninsured1.291.021.63*.0331.160.921.47.2051.581.122.23**.0081.060.761.49.703
    CommercialReferenceReferenceReferenceReference
    Elixhauser score1 to 30.950.741.23.7260.950.741.22.7341.340.961.87.0830.910.631.31.628
    >31.040.791.38.7331.110.861.43.40951.110.791.55.5300.640.430.95*.027
    0ReferenceReferenceReferenceReference
    YCLS respondentFamily member, friend, or caregiver of member0.700.550.89**.0040.960.711.31.82640.790.581.07.1381.5771.012.44*.041
    Member with someone's help0.820.651.02.0870.870.681.11.27410.590.430.804***<.0010.9640.691.33.824
    Skip/prefer not to answer0.240.080.69**.0080.690.222.15.53231.050.372.96.9260.360.101.28.115
    Patient (self)ReferenceReferenceReferenceReference
    NDI1.141.031.25**.0061.111.011.22*.0181.221.081.37**.0011.140.991.32.059
    Housing instability1.921.632.26***<.00010.770.610.98*.0340.850.661.09.208
    Food insecurity2.552.222.93***<.00011.261.021.56*.0300.870.681.10.252
    Transportation hardship1.311.121.54***<.0011.371.161.61***.00010.910.711.17.482
    Medical financial hardship1.120.961.31.1211.221.041.42*.0121.110.901.37.306
    • CI, confidence interval; OR, odds ratio; NDI, Neighborhood Deprivation Index; YCLS, Your Current Life Situation.

    • Estimated ORs and 95% CIs.

    • ↵* P < .05,

    • ↵** P < .01,

    • ↵*** P < .001.

    • View popup
    Table 4.

    Types of Help Requested Among Patients Who Were Risk/Help Discordant

    Housing Instability Discordant N = 1,756Food Insecurity Discordant (N = 1,756)Transportation Hardship Discordant (N = 1,012)Medical Financial Hardship Discordant (N = 512)
    n (%)n (%)n (%)n (%)
    Housing instability570 (32.46)347 (34.29)170 (33.20)
    Food insecurity207 (11.79)211 (20.85)134 (26.17)
    Transportation hardship220 (12.53)242 (13.78)94 (18.36)
    Medical financial hardship607 (34.57)690 (39.29)378 (37.35)
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The Journal of the American Board of Family     Medicine: 34 (5)
The Journal of the American Board of Family Medicine
Vol. 34, Issue 5
September/October 2021
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Patient Interest in Receiving Assistance with Self-Reported Social Risks
Inga Gruß, Alexandra Varga, Neon Brooks, Rachel Gold, Matthew P. Banegas
The Journal of the American Board of Family Medicine Sep 2021, 34 (5) 914-924; DOI: 10.3122/jabfm.2021.05.210069

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Patient Interest in Receiving Assistance with Self-Reported Social Risks
Inga Gruß, Alexandra Varga, Neon Brooks, Rachel Gold, Matthew P. Banegas
The Journal of the American Board of Family Medicine Sep 2021, 34 (5) 914-924; DOI: 10.3122/jabfm.2021.05.210069
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Keywords

  • Financial Stress
  • Integrated Health Care Systems
  • Logistic Models
  • Population Health
  • Referral and Consultation
  • Risk Factors
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