ArticleJournal of general internal medicine2025
Predictive Value of a Financial Strain Question to Pre-screen Individuals for Social Risks.
Article in Journal of general internal medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- Social determinants of health and hospitalization risk in heart failure: A Retrospective analysis.American heart journal plus : cardiology research and practice · 2026Article
- Characterizing intersecting social determinants of health during pregnancy: a descriptive cross-sectional analysis from a northern New England health system.Frontiers in medicine · 2025Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundSocial risks are associated with poor health outcomes and increased costs. Therefore, health systems and policymakers increasingly emphasize social risk screening and interventions. However, universal screening implementation remains challenging due to clinician burnout, lack of evidence, and financial trade-offs. One solution to decrease implementation burden is a two-step social risk screening system where individuals who screen positive for financial strain are then surveyed for other social risks.
objectiveWe analyzed the predictive value of a financial strain screener as a pre-screener for food insecurity, housing instability, and/or transportation barriers.
designLongitudinal study evaluating the proportion of participants endorsing financial strain and other social risks. Data obtained from OCHIN (2017-2023), Humana (2019-2020), and Kaiser Permanente (KP) (2020). We assessed the predictive value (e.g., sensitivity, specificity, positive and negative predictive value, and area under the receiver operating characteristic curve) of using financial strain as a pre-screener for the other social risks.
participantsThe sample included n = 252,845 adults (≥18 years old) with complete data on all four social risks (63.7% from OCHIN, 32.2% from Humana, 4.1% from KP). The response rate varied from 18.7% (Humana) to 23.0% (KP); the OCHIN sample included 21.6% of eligible encounters. MAIN MEASURES: Data related to financial strain, food insecurity, housing instability, and transportation barriers were derived from survey responses and visit-level encounter data. KEY
resultsThe OCHIN sample included 38%, Humana 41%, and KP 28% with financial strain. Using the financial strain item in an initial pre-screening would fail to identify 12.3 to 24.2% of individuals who reported food insecurity, 13.2 to 24.7% who reported housing instability, 17.0 to 32.6% who reported transportation barriers, and 4.1 to 5.7% who reported all three risks.
conclusionsA financial strain pre-screener could lead health systems to miss >10% of people who report food insecurity, housing instability, and/or transportation barriers.
Indexed as
Identifiers
40329034What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.