Screening programs for social determinants of health do not always detect patients who have trouble paying utility bills, according to a Boston Medical Center study published in The Journal of Ambulatory Care Management.
Most states have laws that prohibit utility companies from ending service for low-income families who provide a medical letter confirming a household member has a severe chronic health condition.
Researchers found 2,973 patients at Boston Medical Center received such a letter between 2009 and 2018. Two-thirds of patients were black, and three-fourths were insured through federal programs.
In 2018, Boston Medical Center rolled out an EHR-based social determinants of health screening tool. The hospital screened 70 percent of patients who received a medical letter in 2018, but the tool only identified 16 percent of them as individuals who would have trouble paying utility bills.
"Patients experiencing difficulty paying utility bills may not be detected by systems of care that screen for [social determinants of health], and this is concerning for at-risk populations," Karen Lasser, MD, an internist at Boston Medical Center and professor at the Boston University Schools of Medicine and Public Health, said in a press release. "This research calls for better approaches to identify those needing assistance, to ensure better health outcomes for all patients."
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