Abstract：
OBJECTIVE: Food insecurity (FI) has increasingly become a focus for hospitalized patients. The best methods for screening practices, particularly in hospitalized children, are unknown. The purpose of the study was to evaluate results of an electronic medical record (EMR) embedded, brief screening tool for FI among inpatients.
METHODS: This was a cross-sectional study from August 2020 to September 2022 for all children admitted to a quaternary children\'s hospital. Primary outcomes were proportion of those screened for FI and those identified to have a positive screen. FI was evaluated by The Hunger Vital Sign, a validated 2-question screen verbally obtained in the nursing intake form in the EMR. Covariates include demographic variables of age, sex, race, ethnicity, primary language, and insurance. Statistical analyses including all univariate outcome and bivariate comparisons were performed with SAS 9.4.
RESULTS: There were 31 553 patient encounters with 81.7% screened for FI. Patients had a median age of 6.3 years, were mostly male (54.2%), White (60.6%), non-Hispanic (92.7%), English-speaking (94.3%), and had government insurance (79.8%). Younger (0-2 years), non-White, and noninsured patients were all screened significantly less often for FI (all P < .001). A total of 3.4% were identified as having FI. Patients who were older, non-White, Hispanic, non-English speaking, and had nonprivate insurance had higher FI (all P < .001).
CONCLUSIONS: Despite the use of an EMR screening tool intended to be universal, we found variation in how we screen for FI. At times, we missed those who would benefit the most from intervention, and thus it may be subject to implementation bias.
METHODS: This was a cross-sectional study from August 2020 to September 2022 for all children admitted to a quaternary children\'s hospital. Primary outcomes were proportion of those screened for FI and those identified to have a positive screen. FI was evaluated by The Hunger Vital Sign, a validated 2-question screen verbally obtained in the nursing intake form in the EMR. Covariates include demographic variables of age, sex, race, ethnicity, primary language, and insurance. Statistical analyses including all univariate outcome and bivariate comparisons were performed with SAS 9.4.
RESULTS: There were 31 553 patient encounters with 81.7% screened for FI. Patients had a median age of 6.3 years, were mostly male (54.2%), White (60.6%), non-Hispanic (92.7%), English-speaking (94.3%), and had government insurance (79.8%). Younger (0-2 years), non-White, and noninsured patients were all screened significantly less often for FI (all P < .001). A total of 3.4% were identified as having FI. Patients who were older, non-White, Hispanic, non-English speaking, and had nonprivate insurance had higher FI (all P < .001).
CONCLUSIONS: Despite the use of an EMR screening tool intended to be universal, we found variation in how we screen for FI. At times, we missed those who would benefit the most from intervention, and thus it may be subject to implementation bias.
摘要：
■食品不安全（FI）日益成为住院患者关注的焦点。筛选实践的最佳方法，尤其是住院儿童，是未知的。该研究的目的是评估嵌入的电子病历（EMR）的结果，住院患者FI的简短筛查工具。
■这是一项从2020年8月至2022年9月的横断面研究，针对所有四元儿童医院收治的儿童。主要结果是筛查FI和鉴定为阳性筛查的比例。FI由饥饿生命体征评估，在EMR的护理摄入表中口头获得的经过验证的2个问题屏幕。协变量包括年龄的人口统计学变量，性别,种族,种族,主要语言,和保险。使用SAS9.4进行包括所有单变量结果和双变量比较的统计分析。
■有31553名患者遭遇，81.7%的患者接受了FI筛查。患者的平均年龄为6.3岁，大部分是男性（54.2%），白色（60.6%），非西班牙裔（92.7%），讲英语（94.3％），并有政府保险(79.8%)。年轻（0-2岁），非白色,未参保患者的FI筛查频率均明显较低（均P<.001）。总共3.4%被鉴定为具有FI。年龄较大的病人，非白色,西班牙裔,非英语,非私人保险的FI较高（均P<.001）。
■尽管使用了通用的EMR筛查工具，我们发现我们筛选FI的方式有所不同。有时,我们错过了那些从干预中受益最大的人，因此，它可能会受到实施偏差的影响。
■这是一项从2020年8月至2022年9月的横断面研究，针对所有四元儿童医院收治的儿童。主要结果是筛查FI和鉴定为阳性筛查的比例。FI由饥饿生命体征评估，在EMR的护理摄入表中口头获得的经过验证的2个问题屏幕。协变量包括年龄的人口统计学变量，性别,种族,种族,主要语言,和保险。使用SAS9.4进行包括所有单变量结果和双变量比较的统计分析。
■有31553名患者遭遇，81.7%的患者接受了FI筛查。患者的平均年龄为6.3岁，大部分是男性（54.2%），白色（60.6%），非西班牙裔（92.7%），讲英语（94.3％），并有政府保险(79.8%)。年轻（0-2岁），非白色,未参保患者的FI筛查频率均明显较低（均P<.001）。总共3.4%被鉴定为具有FI。年龄较大的病人，非白色,西班牙裔,非英语,非私人保险的FI较高（均P<.001）。
■尽管使用了通用的EMR筛查工具，我们发现我们筛选FI的方式有所不同。有时,我们错过了那些从干预中受益最大的人，因此，它可能会受到实施偏差的影响。
