# Hospitalized patients' health‐related social needs: A comparison of screenings conducted by hospital staff and research staff

## TL;DR

This study compares how hospital staff and research staff identify patients' health-related social needs and finds that hospital staff may miss some needs.

## Contribution

The study introduces a comparison of HRSN screening practices between hospital and research staff, revealing discrepancies in identification rates.

## Key findings

- Hospital staff identified fewer patients with needs related to medication affordability, housing, food, transportation, and mental health.
- Hospital staff identified a higher proportion of patients needing a usual source of care.
- Agreement between hospital and research staff screenings was fair to moderate (κ = 0.25–0.54).

## Abstract

New policies require hospitals to identify and address patients' health‐related social needs (HRSN) yet provide minimal guidance on how screening should be conducted. This observational study occurred at a large academic hospital serving a diverse population. Hospital and research staff independently screened newly admitted medical patients for six HRSNs using an instrument designed by a quality improvement team. We calculated κ statistics to assess HRSN agreement between hospital and research staff. Analysis of 413 patients revealed fair to moderate agreement between hospital and research staff screenings (κ = 0.25–0.54). Hospital staff identified fewer patients with needs related to medication affordability, housing, food, transportation, and mental health, but identified a higher proportion with needs related to the usual source of care. Hospital staff underestimate the proportion of patients with HRSN, potentially excluding patients from referral to social services.