There is substantial evidence that our daily living and working conditions, including housing, social support, healthcare access, and race, impact our health outcomes. These conditions and characteristics are called the social determinants of health (SDoH). Healthcare settings are increasingly collecting information on the SDoH, which can be used to provide more personalized care and make health system changes (e.g., funding allocation, program development) to improve patient care.
Most of the information on how healthcare settings collect SDoH information, and how they use this data to inform patient care, is focused in primary care settings. We conducted a review of the available literature to describe how SDoH information is collected and used in an inpatient hospital setting, general internal medicine. General internal medicine is an important setting for this research, as it is a large hospital ward that serves many patients who are more vulnerable to experiencing social disadvantage.
This project aims to advance our knowledge of how hospitals collect SDoH information (e.g., which questionnaires are used, the method of data collection, and whether questions are integrated into the the electronic health record), and how it can be used to influence patient care and outcomes (e.g., provision of community organization resources).
We will gain a deeper understanding of the knowledge gaps in this area, which will inform our future research on this topic (see Patients’ perspectives on SDoH collection and use in general internal medicine).
We will disseminate our findings to support health providers, hospital administrators, and decision-makers, who may be considering how to implement the collection and use of this SDoH information in an equitable, feasible, and patient-centered manner.
We have three key findings and discussion points from this research:
- Very few studies report on the collection of SDoH data and its application to patient care in general internal medicine.
- There were a variety of SDoH tools used, and a range of determinants collected. The most frequently collected determinant was food insecurity. The studies focused on material determinants, as opposed to sociodemographic characteristics, such as race.
- Only half of studies applied the data to inform care, most of which involved providing patients with community organization resources to assist with their specific SDoH needs.
- We compared the findings to studies based in primary care, and highlighted the need for integrated care, the potential of incorporating SDoH tools and resources into the electronic health record, and how SDoH data collection could be used to complement a robust social history.