Since the Centers for Medicare & Medicaid Services (CMS) issued guidance to emphasize the importance of social factors that can affect the health outcomes of patients (especially marginalized populations), many Urgent Care centers are prioritizing quality of care initiatives. This means that even in fast-paced settings, we can always do more for our patients — but with limited resources and time, can Urgent Care Centers implement Social Determinants of Health (SDOH) screenings in their practices?
Urgent Care centers play a critical role in providing medical care for individuals in need of immediate attention for non-emergent conditions. Thus, we see first-hand healthcare inequities every day in the patient populations we serve. Urgent Care clinicians focus on treating acute illness or acute manifestations of chronic illness, but it is important to recognize that many of these illnesses are the downstream consequences of unaddressed SDOH. That said, population health can assist in combating health disparities, and Urgent Care centers should not be the last to implement innovative and valuable strategies.
SDOH refer to factors or situations (non-medical) that influence health and access to healthcare. The influence of these social conditions/situations such as homelessness, low literacy, limited access to food and transportation, housing security, education, violence, social support, health behaviors, and poverty can lead to poor health outcomes and overutilization of high-cost care settings. Furthermore, research has solidified the need for healthcare facilities to provide more than just a visit service, especially for patients who have social needs impacting their health.
In the context of Urgent Care, addressing SDOH can play a significant role not only in the patient’s experience, but improving population health and outcomes. By incorporating SDOH screening and interventions, we can better serve those patients who need us the most. For instance, poverty, lack of access to transportation, and lack of insurance can impact a patient’s ability to seek prompt and effective care for an urgent health issue or time sensitive follow-up.
We, as the frontline providers of acute care, can identify and address SDOHs by connecting patients to local resources. Hence, the importance of having partnerships within the community are essential. These partnerships should include community food banks, homeless shelters, domestic violence resource centers, substance abuse and rehabilitation programs, and routine free or low‐cost healthcare clinics. In acute care settings, addressing these conditions might require a coordinated and systemic approach.
By including these social risk factors in the patient diagnosis and addressing them, we can reduce longstanding disparities in health, and healthcare providers can substantiate the increased complexity of these cases. They can also demonstrate the need for higher levels of care and additional care planning. Urgent Care clinicians are capable of providing integrative care delivery models, which aim to address patients’ physical, mental, and social needs while targeting value, quality, and better outcomes.
The Kaiser Family Foundation states, “Although there has been significant progress recognizing and addressing social determinants of health, many challenges remain. Notably, these efforts require working across siloed sectors with separate funding streams, where investments in one sector may accrue savings in another. Moreover, communities may not always have sufficient service capacity or supply to meet identified needs. Further, there remain gaps and inconsistencies in data on social determinants of health that limit the ability to aggregate data across settings or to use data to inform policy and operations, guide quality improvement, or evaluate interventions.”
Addressing SDOH in the Urgent Care setting can be challenging, but the benefits are clear. Clinicians can develop more informed diagnosis and treatment plans with a higher likelihood of success — in addition to improving patient health, increasing patient satisfaction, reducing healthcare costs, improving population health, and strengthening community connections.
While opportunities to advance health equity through clinical care continue to be important, social determinants of health can increase or decrease the risk of poor health outcomes. As healthcare professionals, we must ensure that everyone has access to high quality and equitable care, regardless of their background/circumstances or ability to pay.