Abstract：
BACKGROUND: Home healthcare (HHC) enables patients to receive healthcare services within their homes to manage chronic conditions and recover from illnesses. Recent research has identified disparities in HHC based on race or ethnicity. Social determinants of health (SDOH) describe the external factors influencing a patient\'s health, such as access to care and social support. Individuals from racially or ethnically minoritized communities are known to be disproportionately affected by SDOH. Existing evidence suggests that SDOH are documented in clinical notes. However, no prior study has investigated the documentation of SDOH across individuals from different racial or ethnic backgrounds in the HHC setting. This study aimed to (1) describe frequencies of SDOH documented in clinical notes by race or ethnicity and (2) determine associations between race or ethnicity and SDOH documentation.
METHODS: Retrospective data analysis.
METHODS: We conducted a cross-sectional secondary data analysis of 86,866 HHC episodes representing 65,693 unique patients from one large HHC agency in New York collected between January 1, 2015, and December 31, 2017. We reported the frequency of six SDOH (physical environment, social environment, housing and economic circumstances, food insecurity, access to care, and education and literacy) documented in clinical notes across individuals reported as Asian/Pacific Islander, Black, Hispanic, multi-racial, Native American, or White. We analyzed differences in SDOH documentation by race or ethnicity using logistic regression models.
RESULTS: Compared to patients reported as White, patients across other racial or ethnic groups had higher frequencies of SDOH documented in their clinical notes. Our results suggest that race or ethnicity is associated with SDOH documentation in HHC.
CONCLUSIONS: As the study of SDOH in HHC continues to evolve, our results provide a foundation to evaluate social information in the HHC setting and understand how it influences the quality of care provided.
CONCLUSIONS: The results of this exploratory study can help clinicians understand the differences in SDOH across individuals from different racial and ethnic groups and serve as a foundation for future research aimed at fostering more inclusive HHC documentation practices.
METHODS: Retrospective data analysis.
METHODS: We conducted a cross-sectional secondary data analysis of 86,866 HHC episodes representing 65,693 unique patients from one large HHC agency in New York collected between January 1, 2015, and December 31, 2017. We reported the frequency of six SDOH (physical environment, social environment, housing and economic circumstances, food insecurity, access to care, and education and literacy) documented in clinical notes across individuals reported as Asian/Pacific Islander, Black, Hispanic, multi-racial, Native American, or White. We analyzed differences in SDOH documentation by race or ethnicity using logistic regression models.
RESULTS: Compared to patients reported as White, patients across other racial or ethnic groups had higher frequencies of SDOH documented in their clinical notes. Our results suggest that race or ethnicity is associated with SDOH documentation in HHC.
CONCLUSIONS: As the study of SDOH in HHC continues to evolve, our results provide a foundation to evaluate social information in the HHC setting and understand how it influences the quality of care provided.
CONCLUSIONS: The results of this exploratory study can help clinicians understand the differences in SDOH across individuals from different racial and ethnic groups and serve as a foundation for future research aimed at fostering more inclusive HHC documentation practices.
摘要：
背景：家庭医疗保健（HHC）使患者能够在家中接受医疗保健服务，以管理慢性病并从疾病中康复。最近的研究已经确定了基于种族或族裔的HHC差异。健康的社会决定因素(SDOH)描述了影响患者健康的外部因素，例如获得护理和社会支持。已知来自种族或少数民族社区的个人受到SDOH的影响不成比例。现有证据表明，SDOH已记录在临床笔记中。然而,之前没有研究调查过在HHC设置中来自不同种族或民族背景的个体的SDOH记录.这项研究旨在（1）按种族或种族描述临床记录中记录的SDOH的频率，以及（2）确定种族或种族与SDOH文献之间的关联。
方法：回顾性数据分析。
方法：我们在2015年1月1日至2017年12月31日收集了来自纽约一家大型HHC机构的86,866例HHC发作，代表65,693例独特患者的横截面二次数据分析。我们报告了六个SDOH(物理环境，社会环境,住房和经济环境，粮食不安全，获得护理，以及教育和识字）记录在报告为亚洲/太平洋岛民的个人的临床笔记中，黑色,西班牙裔,多种族,美洲原住民,或白色。我们使用逻辑回归模型按种族或种族分析了SDOH文献的差异。
结果：与报告为白色的患者相比，其他种族或族裔的患者在其临床记录中记录的SDOH发生频率较高.我们的结果表明，种族或种族与HHC中的SDOH文献有关。
结论：随着对HHC中SDOH的研究不断发展，我们的结果为评估HHC设置中的社会信息以及了解其如何影响所提供护理质量提供了基础.
结论：这项探索性研究的结果可以帮助临床医生了解来自不同种族和族裔群体的个体之间SDOH的差异，并为未来旨在促进更具包容性的HHC文献实践的研究奠定基础。
方法：回顾性数据分析。
方法：我们在2015年1月1日至2017年12月31日收集了来自纽约一家大型HHC机构的86,866例HHC发作，代表65,693例独特患者的横截面二次数据分析。我们报告了六个SDOH(物理环境，社会环境,住房和经济环境，粮食不安全，获得护理，以及教育和识字）记录在报告为亚洲/太平洋岛民的个人的临床笔记中，黑色,西班牙裔,多种族,美洲原住民,或白色。我们使用逻辑回归模型按种族或种族分析了SDOH文献的差异。
结果：与报告为白色的患者相比，其他种族或族裔的患者在其临床记录中记录的SDOH发生频率较高.我们的结果表明，种族或种族与HHC中的SDOH文献有关。
结论：随着对HHC中SDOH的研究不断发展，我们的结果为评估HHC设置中的社会信息以及了解其如何影响所提供护理质量提供了基础.
结论：这项探索性研究的结果可以帮助临床医生了解来自不同种族和族裔群体的个体之间SDOH的差异，并为未来旨在促进更具包容性的HHC文献实践的研究奠定基础。
