Health-screening tool identifies housing, food insecurity among patients on hemodialysis
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Key takeaways:
- In the study, 44% of patients screened positive for housing insecurity.
- Overall, 63% of patients screened positive for food insecurity.
The Accountable Health Communities Health-Related Social Needs Screening Tool may be effective in identifying health-related social needs among hemodialysis patients, data show.
“There is mounting evidence that health-related social needs are prominent among people on hemodialysis and contribute to disparities in outcomes,” Tessa Novick, MD, MSW, MHS, a nephrologist at The University of Texas at Austin, and colleagues, wrote.
Researchers screened and interviewed 32 adults receiving hemodialysis about their health-related social needs. The study aimed to evaluate the sensitivity and specificity of the AHC screening tool among patients on hemodialysis.
Patients completed the AHC screening tool during a hemodialysis session at three dialysis centers in Austin, Texas. Interviews were conducted in English or Spanish, based on the patients’ preference. Patients screened positive for housing insecurity if they reported “not having a steady place to live” or “having a steady place to live but being worried about losing it in the future.” Researchers used two prompts to gauge food insecurity: Individuals screened positive if, in the past 12 months, they “worried their food would run out before getting money to buy more” or “the food they bought just didn’t last and they didn’t have enough money to buy more.”
Researchers found 14 patients (44%) screened positive for housing insecurity and 10 patients (31%) were found to be housing insecure.
In terms of food insecurity, 50% of patients screened positive using the first prompt, 56% screened positive using the second and 63% had a positive response to at least one question. Twenty-one patients were food insecure during interviews.
“We found that the AHC housing insecurity question was highly sensitive and specific,” the researchers wrote. “Food insecurity questions had lower sensitivity and specificity, but sensitivity improved when answers to two questions were considered together.”
The study had some limitations, including a small sample size and single city setting, which may limit generalizability, researchers wrote. Additionally, patients’ comfort level with interviewers who were not of the same race, ethnicity or gender may have influenced results.
“Future, larger-scale efforts to assess health-related social needs among people with kidney failure could enable earlier identification and intervention with potential for improved clinical outcomes,” the researchers wrote.
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