PDF(Pubmed)
Abstract：
Health systems are increasingly assessing and addressing social needs with referrals to community resources. The objective of this randomized controlled trial was to randomize adult Medicaid members with type 2 diabetes to receive usual care (n = 239) or social needs navigation (n = 234) for 6 months and compare HbA1c (primary outcome), quality of life (secondary outcome), and other exploratory outcomes with t-tests and mixed-effects regression. Eligible participants had an HbA1c test in claims in the past 120 days and reported 1+ social needs. Data were collected from November 2019 to July 2023. Surveys were completed at baseline and at 3-, 6-, and 12-month follow-up. Health plan data included care management records and medical and pharmacy claims. The sample was from Louisiana, USA, M = 51.6 (SD = 9.5) years old, 76.1% female, 66.5% Black, 29.4% White, and 3.0% Hispanic. By design, more navigation (91.5%) vs. usual care (6.7%) participants had a care plan. Social needs persisted for both groups. No group differences in HbA1c tests and values were observed, though the large amount of missing HbA1c lab values reduced statistical power. No group differences were observed for other outcomes. Proactively eliciting and attempting to provide referrals and resources for social needs did not demonstrate significant health benefits or decrease healthcare utilization in this sample.
摘要：
卫生系统越来越多地通过转介社区资源来评估和满足社会需求。这项随机对照试验的目的是将患有2型糖尿病的成年Medicaid成员随机接受常规护理（n=239）或社会需求导航（n=234）6个月，并比较HbA1c（主要结果）。生活质量（次要结果），以及其他探索性结果，采用t检验和混合效应回归。符合条件的参与者在过去120天内进行了HbA1c测试，并报告了1+社会需求。数据收集时间为2019年11月至2023年7月。调查在基线和3-6-，和12个月的随访。健康计划数据包括护理管理记录以及医疗和药房索赔。样本来自路易斯安那州,美国,M=51.6（SD=9.5）岁，76.1%为女性，66.5%黑色,29.4%白色，和3.0%的西班牙裔。根据设计，更多导航（91.5%）与常规护理(6.7%)参与者有护理计划.这两个群体的社会需求持续存在。在HbA1c测试和值没有观察到组差异，尽管大量缺失的HbA1c实验室值降低了统计功效。其他结果没有观察到组间差异。在此样本中，主动激发并尝试为社会需求提供转诊和资源并未显示出显着的健康益处或降低医疗保健利用率。
