Comparing management of food insecure patients across two practice models within a health system in coastal Virginia
Poster #: 107
Session/Time: B
Author:
Sarah Mohiuddin, BS
Mentor:
John Harrington, MD
Research Type: Clinical Research
Abstract
INTRODUCTION:
Food insecurity (FI) is a critical social determinant of health affecting pediatric populations. At Children's Hospital of The King's Daughters Health System (CHKDHS), FI is screened during well visits using the Safe Environment for Every Kid (SEEK) questionnaire. Prior work demonstrated higher FI prevalence among General Academic Pediatrics (GAP) patients, who primarily have Medicaid coverage, compared to Children's Medical Group (CMG) patients, who represent a mixed-insurance population. Previous findings also highlighted inconsistent documentation and limited interventions for FI-positive patients. Objective: This study compares referral patterns and follow-up care for food-insecure patients across two CHKDHS practice models: CMG and GAP.
METHODS:
Retrospective analysis was conducted using SEEK screening data from April 2022 to May 2024. The total number of screened patients, FI-positive cases, referrals, and follow-up data were extracted and analyzed for each clinic.
RESULTS:
At CMG, 51,740 patients were screened, identifying 2,238 (4.33%) as food insecure. At GAP, 14,615 patients were screened, with 1,110 (7.59%) positive for FI. Referral rates differed significantly: 24% of FI-positive CMG patients received a referral recommendation, compared to 63% at GAP. Only 12% of CMG referrals were actionable, whereas GAP used no handouts in place of referrals. Follow-up documentation was higher at GAP (38.5%) than CMG (23.8%). Social work was a common referral in both groups; however, CMG referrals emphasized community interventions, while GAP utilized private non-medical organizations. CMG providers frequently documented "referral given" rather than patient-specific concerns (15.2% vs 62.3% at GAP).
CONCLUSION:
GAP providers were more likely to document FI-related concerns, recommend actionable referrals, and complete follow-up. In contrast, CMG providers relied more on handouts and had lower follow-up rates, likely reflecting higher patient volumes and fewer embedded social work resources. These findings suggest the need for standardized referral protocols, increased integration of social workers, and potential reimbursement enhancements to support SDOH interventions in outpatient pediatric settings.
Food insecurity (FI) is a critical social determinant of health affecting pediatric populations. At Children's Hospital of The King's Daughters Health System (CHKDHS), FI is screened during well visits using the Safe Environment for Every Kid (SEEK) questionnaire. Prior work demonstrated higher FI prevalence among General Academic Pediatrics (GAP) patients, who primarily have Medicaid coverage, compared to Children's Medical Group (CMG) patients, who represent a mixed-insurance population. Previous findings also highlighted inconsistent documentation and limited interventions for FI-positive patients. Objective: This study compares referral patterns and follow-up care for food-insecure patients across two CHKDHS practice models: CMG and GAP.
METHODS:
Retrospective analysis was conducted using SEEK screening data from April 2022 to May 2024. The total number of screened patients, FI-positive cases, referrals, and follow-up data were extracted and analyzed for each clinic.
RESULTS:
At CMG, 51,740 patients were screened, identifying 2,238 (4.33%) as food insecure. At GAP, 14,615 patients were screened, with 1,110 (7.59%) positive for FI. Referral rates differed significantly: 24% of FI-positive CMG patients received a referral recommendation, compared to 63% at GAP. Only 12% of CMG referrals were actionable, whereas GAP used no handouts in place of referrals. Follow-up documentation was higher at GAP (38.5%) than CMG (23.8%). Social work was a common referral in both groups; however, CMG referrals emphasized community interventions, while GAP utilized private non-medical organizations. CMG providers frequently documented "referral given" rather than patient-specific concerns (15.2% vs 62.3% at GAP).
CONCLUSION:
GAP providers were more likely to document FI-related concerns, recommend actionable referrals, and complete follow-up. In contrast, CMG providers relied more on handouts and had lower follow-up rates, likely reflecting higher patient volumes and fewer embedded social work resources. These findings suggest the need for standardized referral protocols, increased integration of social workers, and potential reimbursement enhancements to support SDOH interventions in outpatient pediatric settings.