Abstract

Background

Encouraged by multiple federal policies, healthcare organizations are assuming greater responsibility for patients' social needs. This study describes the individual and co-occurring social needs that lead to a referral to social workers in primary care.

Methods

In a secondary data analysis of a longitudinal cohort, we used natural language processing (NLP) to categorize reasons for social work referral documented in electronic health records referral orders (n = 9,473) from a federally qualified health center (2011–2016) in the United States, using a literature-derived classification scheme. We used market basket analysis (MBA) to identify co-occurring social needs.

Results

The most frequent needs leading to a social work referral were financial (25%), pregnancy (25%), behavioral health (16%), and family/social support (9%) needs. The most frequently co-occurring needs are pregnancy with language limitation (support = 0.07; confidence = 0.78); behavioral health with family/social support (support = 0.03; confidence = 0.28); and financial with behavioral health (support = 0.025; confidence = 0.14).

Conclusion

The diversity of reasons for social work referrals signifies the complexities of social needs among patients and the potential role for social workers in addressing these needs. A clearer understanding of patients’ social needs helps inform social work staffing decisions and the development of effective intervention packages to address patients’ social needs.

中文翻译：

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城市安全网人口中转介社会工作的原因：一种自然语言处理和市场篮子分析方法

摘要

背景

在多项联邦政策的鼓励下，医疗机构对患者的社会需求承担了更大的责任。这项研究描述了个人和共同出现的社会需求，这些需求导致转诊初级保健中的社会工作者。

方法

在纵向队列的辅助数据分析中，我们使用自然语言处理（NLP）对来自联邦合格医疗中心（2011-2016）的电子健康记录转诊令（n = 9,473）中记录的社会工作转诊原因进行分类。美国，使用文献衍生的分类方案。我们使用市场购物篮分析（MBA）来确定共同发生的社会需求。

结果

导致进行社会工作转介的最常见需求是财务（25％），怀孕（25％），行为健康（16％）和家庭/社会支持（9％）需求。同时发生的最常见需求是怀孕且语言受限（支持= 0.07；置信度= 0.78）；有家庭/社会支持的行为健康（支持= 0.03;置信度= 0.28）; 行为健康（支持= 0.025；置信度= 0.14）。

结论

转介社会工作的原因多种多样，这表明患者之间社会需求的复杂性，以及社会工作者在满足这些需求方面的潜在作用。对患者社会需求的更清晰了解有助于为社会工作人员配备决策和制定有效的干预措施以解决患者的社会需求提供信息。